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[Pharmacokinetics of cefodizime in patients undergoing hemodialysis]
N Itagaki1, H Hasegawa, M Sakaguchi
1Third Department of Internal Medicine, Kinki University School of Medicine.
Insights
For patients with chronic renal failure undergoing hemodialysis (HD), administering cefodizime (CDZM) after HD sessions is most effective. Dosing of 1g for mild and 2g for severe infections prevents drug accumulation.
Area of Science:
- Pharmacokinetics and pharmacodynamics of antibiotics.
- Clinical pharmacology in renal impairment.
Context:
- Chronic renal failure (CRF) significantly alters drug metabolism and excretion.
- Hemodialysis (HD) is a life-sustaining treatment for CRF patients, necessitating careful drug regimen adjustments.
- Cefodizime (CDZM) is a third-generation cephalosporin with potential utility in patients with renal impairment.
Purpose:
- To determine the optimal cefodizime (CDZM) dosing regimen for patients with chronic renal failure (CRF) undergoing hemodialysis (HD).
- To evaluate the pharmacokinetic profile of CDZM in CRF patients during and after hemodialysis.
- To establish safe and effective CDZM serum concentrations for antibacterial activity in HD patients.
Summary:
- The elimination half-life (T 1/2 beta) of intravenous CDZM was significantly shorter during hemodialysis (3.50 +/- 0.72 hours) compared to off-HD periods (11.26 +/- 3.89 hours).
- Administering 1g or 2g of CDZM exclusively after hemodialysis sessions maintained therapeutic serum concentrations without observable drug accumulation.
- The recommended regimen involves post-hemodialysis administration: 1g for mild infections and 2g for severe infections.
Impact:
- Provides evidence-based dosing guidelines for cefodizime in hemodialysis patients.
- Aims to optimize antibiotic efficacy and minimize toxicity in a vulnerable patient population.
- Contributes to improved management strategies for infections in chronic renal failure patients undergoing hemodialysis.
Abstract:
The object of this study was to establish the most effective regimen of cefodizime (CDZM) for patients with chronic renal failure undergoing hemodialysis (HD). T 1/2 beta of CDZM upon 1 g intravenous administration was 3.50 +/- 0.72 hours in an on-HD group, and it was 11.26 +/- 3.89 hours in an off-HD group. When CDZM was administered consecutively at a dose of 1 g or 2 g only after HD, the serum concentration of CDZM was maintained at levels sufficient to exert antibacterial activity, and no tendency for accumulation was observed. The most effective regimen of CDZM to HD patients, therefore, has been that in which concluded to administration was done only after completion of HD, in a dose of 1 g for mild infections and that of 2 g for severe infections.