title: Pharmacokinetics of clindamycin in the plasma and dialysate after intraperitoneal administration of clindamycin phosphoester to patients on continuous ambulatory peritoneal dialysis: an open-label, prospective, single-dose, two-institution study.
abstract: We evaluated the pharmacokinetics of clindamycin and the dose of clindamycin phosphate necessary to treat peritonitis after intraperitoneal administration of clindamycin phosphate to patients on continuous ambulatory peritoneal dialysis (CAPD). This was an open-label, prospective, single-dose study conducted at the two levels of institutional clinical care in South Korea. Twelve patients (six men and six women; all older than 25 years), mean CAPD duration of 38.2 months with various origins without peritonitis, received 600 mg clindamycin phosphate mixed with only the first 2-L dialysate (1.5% dextrose). The 1.5%, 1.5%, 2.5% and 1.5% dextrose dialysates were serially exchanged every 6 hr. If patients were non-anuric, 24-hr urine samples were also collected. Clindamycin phosphate was incompletely activated to clindamycin in the dialysate. The clindamycin concentration in the dialysate was greater than the effective concentration (5 μg/mL) at 6.87 μg/mL up to 6 hr. So, 600 mg clindamycin phosphate per every 6 hr dialysate is effective for treatment of peritonitis. It has been reported that the clindamycin concentrations in the dialysate may be higher in CAPD patients with peritonitis. Thus, we can expect that intraperitoneal administration of <600 mg clindamycin phosphate per every 6 hr dialysate could be maintained over 5 μg/mL in patients with peritonitis. The transfer of clindamycin was unidirectional from the dialysate to the plasma.
authors.affiliation: College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, South Korea.
authors.forename: Min J
authors.initials: MJ
authors.lastname: Chang
authors.forename: Hyunguk
authors.initials: H
authors.lastname: Namgung
authors.forename: Hye D
authors.initials: HD
authors.lastname: Choi
authors.forename: Young R
authors.initials: YR
authors.lastname: Song
authors.forename: Sung G
authors.initials: SG
authors.lastname: Kim
authors.forename: Jung M
authors.initials: JM
authors.lastname: Oh
authors.forename: Wan G
authors.initials: WG
authors.lastname: Shin
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics*; D002981:Clindamycin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000097:blood / Q000493:pharmacokinetics; D015314:Dialysis Solutions / Q000008:administration & dosage / Q000378:metabolism / Q000627:therapeutic use*; D054796:Drug Dosage Calculations; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D010538:Peritonitis / Q000097:blood / Q000382:microbiology / Q000517:prevention & control*; D011446:Prospective Studies; D056910:Republic of Korea; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D015314:Dialysis Solutions; D002981:Clindamycin; C007084:clindamycin phosphate