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Related Experiment Videos

Intermittent intraperitoneal ceftazidime dosing in end-stage renal disease

F Dumler1, L Gottschling, G Umstead

  • 1Department of Medicine, William Beaumont Hospital, Royal Oak, Michigan 48073, USA.

ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|November 6, 1998
PubMed
Summary

Intraperitoneal ceftazidime every 48 hours offers a practical alternative for outpatient antibiotic therapy in peritoneal dialysis patients, reducing burdens associated with parenteral administration. Further research is needed to determine its efficacy in treating peritonitis.

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Area of Science:

  • Nephrology
  • Pharmacokinetics
  • Infectious Diseases

Background:

  • Infections are a significant concern for patients undergoing dialysis.
  • Shortened hospital stays necessitate effective outpatient antibiotic strategies.
  • Parenteral antibiotic administration presents logistical and financial challenges, while daily intraperitoneal dosing risks contamination.

Purpose of the Study:

  • To investigate the pharmacokinetics of intraperitoneal ceftazidime in chronic peritoneal dialysis patients.
  • To evaluate the feasibility of thrice-weekly intraperitoneal dosing of ceftazidime.
  • To assess ceftazidime stability and serum/dialysate concentrations.

Main Methods:

  • Seven stable chronic peritoneal dialysis patients received a 2g loading dose followed by 1.5g every 48 hours.

Related Experiment Videos

  • In vitro stability of ceftazidime at 4°C was assessed using high-performance liquid chromatography.
  • Serum and dialysate concentrations were measured over 48 hours to determine pharmacokinetic parameters.

    • Main Results:

    • Ceftazidime demonstrated 91% stability in vitro at 120 hours.
    • Peak serum concentrations were achieved at 4.9 hours, with significant levels remaining at 24 and 48 hours.
    • Median trough dialysate levels at 48 hours were lower than serum levels (2.8 vs 8.5 microg/ml, p=0.0425).
    • Key pharmacokinetic parameters included bioavailability (88%), volume of distribution (20 L), and elimination half-life (11.4 hours).

    Conclusions:

    • Intraperitoneal ceftazidime administered every 48 hours is a viable alternative to parenteral therapy for non-peritoneal infections in dialysis patients.
    • The study highlights the practical advantages of this dosing regimen.
    • The effectiveness of this regimen in treating peritonitis, considering potential changes in dialysate permeability, requires further investigation.