PHARMACOKINETICS OF MOXIFLOXACIN IN PATIENTS UNDERGOING CONTINUOUS AMBULATORY PERITONEAL DIALYSIS

• Published in: Peritoneal dialysis international 2009-09, Vol.29 (5), p.575-579
• Main Authors: Skalioti, Chrysanthi, Tsaganos, Thomas, Stamatiadis, Dimitrios, Giamarellos-Bourboulis, Evangelos J, Boletis, John, Kanellakopoulou, Kyriaki
• Format: Article
• Language: English
• Subjects: Administration, Oral; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anti-Infective Agents - administration & dosage; Anti-Infective Agents - pharmacokinetics; Ascitic Fluid - chemistry; Aza Compounds - administration & dosage; Aza Compounds - pharmacokinetics; Biological and medical sciences; Chromatography, High Pressure Liquid; Emergency and intensive care: renal failure. Dialysis management; Fluoroquinolones; Glomerulonephritis; Humans; Intensive care medicine; Medical sciences; Moxifloxacin; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Peritoneal Dialysis, Continuous Ambulatory; Quinolines - administration & dosage; Quinolines - pharmacokinetics
• ISSN: 0896-8608; 1718-4304
• DOI: 10.1177/089686080902900517

To investigate the effect of continuous ambulatory peritoneal dialysis (CAPD) on plasma and peritoneal fluid concentration and pharmacokinetics of moxifloxacin after administration of one 400 mg dose orally to end-stage renal failure patients undergoing CAPD. Blood and peritoneal samples were collected from 8 patients at standard time intervals and concentrations of moxifloxacin were estimated by HPLC analysis with fluorometric and ultraviolet detection. Pharmacokinetic parameters were estimated using standard noncompartmental methods. Median maximum plasma moxifloxacin concentration was 5.86 mg/L at a median time of 1.25 hours. In serum, median area under the concentration-time curve (AUC(0-->inf)) was 157.95 +/- 100.34 mg.hour/L, median t(1/2) 25.00 hours, median clearance 2.54 L/hour, and median distribution volume 94.90 L. Median peritoneal fluid-to-plasma ratio of moxifloxacin ranged between 0.84 and 1.00, denoting adequate penetration and lack of considerable moxifloxacin removal during CAPD. Maximum moxifloxacin concentration/minimum inhibitory concentration (MIC) and AUC(0-->24)/MIC ratios were above the cutoff points that indicate clinical success. A single 400 mg oral dose of moxifloxacin is safe, presents rapid peritoneal fluid penetration, has similar plasma and peritoneal fluid pharmacokinetics, and should therefore be efficacious in the treatment of CAPD-induced peritonitis.