Pharmacokinetics of ciprofloxacin in ICU patients on continuous veno-venous haemodiafiltration
Autor: | Steven C. Wallis, Jeffrey Lipman, Claire M. Rickard, Dan Mullany, Peter J. Daley |
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Rok vydání: | 2001 |
Předmět: |
Adult
Male medicine.medical_specialty Metabolic Clearance Rate medicine.medical_treatment Hemodiafiltration Critical Care and Intensive Care Medicine law.invention Anti-Infective Agents Pharmacokinetics Ciprofloxacin law Intensive care Hemofiltration medicine Humans Urea Prospective Studies Renal replacement therapy Infusions Intravenous Aged Antibacterial agent business.industry Acute Kidney Injury Middle Aged Intensive care unit Surgery Intensive Care Units Area Under Curve Pharmacodynamics Anesthesia Female Hemodialysis business |
Zdroj: | Intensive Care Medicine. 27:665-672 |
ISSN: | 1432-1238 0342-4642 |
Popis: | Objectives: To investigate the pharmacokinetics of intravenous ciprofloxacin 200 mg every 8 h in critically ill patients on continuous veno-venous haemodiafiltration (CVVHDF), one form of continuous renal replacement therapy (CRRT). Design and setting: Open, prospective clinical study in a multidisciplinary, intensive care unit in a university-affiliated tertiary referral hospital. Patients: Six critically ill patients with acute renal failure on CVVHDF. Interventions: Timed blood and ultrafiltrate samples were collected to allow pharmacokinetics and clearances to be calculated of initial and subsequent doses of 200 mg intravenous ciprofloxacin. CVVHD was performed with 1 l/h of dialysate and 2 l/h of predilution filtration solution, producing 3 l/h of dialysis effluent. The blood was pumped at 200 ml/min using a Gambro BMM-10 blood pump through a Hospal AN69HF haemofilter. Measurements and results: Ten pharmacokinetic profiles were measured. The CVVHDF displayed a urea clearance of 42±3 ml/min, and removed ciprofloxacin with a clearance of 37±7 ml/min. This rate was 2–2.5 greater than previously published for ciprofloxacin in other forms of CRRT. On average the CVVHDF was responsible for clearing a fifth of all ciprofloxacin eliminated (21±10%). The total body clearance of ciprofloxacin was 12.2±4.3 l/h. The trough concentration following the initial dose was 0.7±0.3 mg/l. The area under the plasma concentration time curves over a 24-h period ranged from 21 to 55 mg·h l–1. Conclusions: Intravenous ciprofloxacin 600 mg/day in critically ill patients using this form of CRRT produced adequate plasma levels for many resistant microbes found in intensive care units. |
Databáze: | OpenAIRE |
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