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Cefoxitin disposition during peritoneal dialysis

W L Greaves, J H Kreeft, R I Ogilvie

    Antimicrobial Agents and Chemotherapy
    |February 1, 1981
    PubMed
    Summary
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    This study investigated cefoxitin pharmacokinetics in patients with chronic renal failure undergoing peritoneal dialysis. Results show cefoxitin clearance is reduced in renal failure and not enhanced by dialysis.

    Area of Science:

    • Pharmacokinetics and Drug Metabolism
    • Nephrology and Dialysis
    • Infectious Diseases and Pharmacology

    Background:

    • Chronic renal failure (CRF) significantly alters drug pharmacokinetics, necessitating dose adjustments.
    • Continuous ambulatory peritoneal dialysis (CAPD) is a treatment for end-stage renal disease, impacting drug elimination.
    • Understanding cefoxitin disposition in CAPD patients is crucial for effective antibiotic therapy.

    Purpose of the Study:

    • To determine the pharmacokinetic profile of cefoxitin in patients with CRF on CAPD.
    • To evaluate the impact of CAPD on cefoxitin elimination and clearance.
    • To provide data for optimizing cefoxitin dosing in this patient population.

    Main Methods:

    • Intravenous administration of 2 g cefoxitin over 30 minutes to six CAPD patients.

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  • Measurement of plasma drug concentrations over time to determine pharmacokinetic parameters.
  • Calculation of peritoneal clearance and comparison with plasma clearance.

    • Main Results:

    • Mean cefoxitin elimination half-life (t1/2) was 7.8 hours.
    • Mean apparent volume of distribution was 0.267 L/kg.
    • Peritoneal clearance was low (1.51 ml/min), representing only 7.4% of plasma clearance; cefoxitin clearance was reduced and not increased by CAPD.

    Conclusions:

    • Cefoxitin clearance is significantly reduced in patients with chronic renal failure.
    • Continuous ambulatory peritoneal dialysis does not effectively enhance cefoxitin elimination.
    • Dosing adjustments for cefoxitin may be necessary in patients with renal impairment undergoing CAPD.