title: Pharmacokinetics and pharmacodynamics of ciprofloxacin in critically ill patients after the first intravenous administration of 400 mg.
abstract: OBJECTIVE
  To investigate the pharmacokinetics and pharmacodynamics of ciprofloxacin in critically ill patients after the first intravenous administration of 400 mg.
  
  
  METHODS
  Plasma concentrations were measured in 20 critically ill patients (mean [SD]; age, 55.5 [16.5] years; weight, 80.3 [16.9] kg; and creatinine clearance, 110.0 [71.5] mL/min). Four blood samples were drawn at the following time points 0, 0.5, 6 , 8 hours after infusion. Ciprofloxacin concentrations were determined by high-performance liquid chromatography.
  
  
  RESULTS
  In the cases where ciprofloxacin was applied in targeted antibiotic therapy the minimum inhibitory concentrations (MIC) were ≤0.5 mg/l. The maximum and minimum plasma concentrations of ciprofloxacin were 1.74 (0.58-7.90) and 0.45 (0.16-2.96) mg/l, respectively. The main pharmacokinetic parameters for ciprofloxacin in the analyzed patients were as follows: k(el), 0.21 h-1; t(1/2kel), 3.37 h; AUC(0-inf), 10.10 mg×h/l; AUMC(0-last), 15.36 mg×h(2)/l; MRT, 1.71 h; V(d), 214.8 l; Cl, 39.70 l/h. Considering the maximum value of MIC (0.5 mg/l) only 30% and 25% of analyzed patients had desired values of the PK/PD indexes AUIC>125 and C(max) /MIC>10, respectively.
  
  
  CONCLUSIONS
  The target plasma concentrations after the first dose of ciprofloxacin were reached only in a few critically ill patients. Considerable inter-subject variability for PK/PD parameters in ICU patients requires systematic monitoring.
authors.affiliation: Department of Clinical Pharmacy and Biopharmacy, University of Medical Sciences, Poznań, Poland. szalekedyta@wp.pl
authors.forename: E
authors.initials: E
authors.lastname: Szałek
authors.forename: H
authors.initials: H
authors.lastname: Tomczak
authors.forename: A
authors.initials: A
authors.lastname: Kamińska
authors.forename: T
authors.initials: T
authors.lastname: Grabowski
authors.forename: P
authors.initials: P
authors.lastname: Smuszkiewicz
authors.forename: K
authors.initials: K
authors.lastname: Matysiak
authors.forename: A
authors.initials: A
authors.lastname: Wolc
authors.forename: Z
authors.initials: Z
authors.lastname: Kaczmarek
authors.forename: E
authors.initials: E
authors.lastname: Grześkowiak
mesh_terms: D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology; D019540:Area Under Curve; D002939:Ciprofloxacin / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000494:pharmacology*; D016638:Critical Illness; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents; D002939:Ciprofloxacin