The administration of ciprofloxacin during continuous renal replacement therapy: pilot study

Continuous renal replacement therapy (CRRT) is a common technique in critically ill patients. However, there is no uniformity in the pharmacokinetics of ciprofloxacin (CPFX) used during CRRT. The aims of the present study were to estimate the pharmacokinetics of CPFX and to determine the appropriate administration of CPFX for critically ill patients undergoing CRRT. The pharmacokinetics of ciprofloxacin total clearance (CL(tot)) was calculated based on the creatinine clearance (CL(cre)), dialysate flow (QD), and ultrafiltrate flow (QF) as follows: CL(tot(L/h)) = (4.83 CL(cre(L/h)) + 6.41) + 0.92 (QD + Q(F(L/h))) based on in vitro study using CRRT circuit model. We administered CPFX to critically ill patients based on the CL(tot), which was 50 x CL(tot(L/h)) (mg/day). We confirmed that the CPFX concentrations reached higher than optimal concentrations, and infection was successfully controlled in these patients.