Related Experiment Videos
Roxithromycin disposition in patients on continuous ambulatory peritoneal dialysis
Y W Lam1, J F Flaherty, L Yumena
1Department of Pharmacology, University of Texas Health Science Center, San Antonio, USA.
The Journal of Antimicrobial Chemotherapy
|July 1, 1995
Summary
Roxithromycin elimination is prolonged in patients with end-stage renal disease, with minimal removal during continuous ambulatory peritoneal dialysis. This macrolide antibiotic shows reduced clearance in renal failure.
Area of Science:
- Pharmacology
- Nephrology
- Infectious Diseases
Background:
- Roxithromycin, a macrolide antibiotic, offers a pharmacokinetic profile superior to erythromycin.
- Its absorption is more reliable, leading to higher and sustained plasma and tissue concentrations.
Purpose of the Study:
- To investigate the pharmacokinetics of roxithromycin in patients with end-stage renal disease (ESRD).
- To determine the dialysis clearance of roxithromycin during continuous ambulatory peritoneal dialysis (CAPD).
Main Methods:
- Twelve ESRD patients undergoing CAPD received a single 300 mg oral dose of roxithromycin.
- Blood, dialysate, and urine samples were collected over 48 hours.
- Roxithromycin levels were quantified using a microbiological assay.
Main Results:
- Peak plasma concentrations (2.3–6.8 mg/L) were achieved between 0.5 and 5 hours.
- The mean elimination half-life was significantly prolonged to 20.6 ± 8.7 hours compared to healthy volunteers.
- Low recovery in dialysate (1.0–3.1%) and urine (1%) indicated minimal removal by CAPD.
Conclusions:
- Roxithromycin is not significantly cleared by CAPD in ESRD patients.
- The drug's elimination is impaired in renal failure, likely due to reduced nonrenal clearance pathways.