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Pharmacokinetics of ciprofloxacin in ICU patients on continuous ven-venous haemodiafiltration
journal contribution
posted on 2023-05-16, 18:07 authored by Wallis, S, Mullany, DV, Lipman, J, Rickard, CM, Daley, PJObjectives: To investigate the pharmacokinetics of intravenous ciprofloxacin 200 mg every 8 h in critically ill patients on continuous veno-venous haemodiafiltration (CVVHDF), one form of continuous renal replacement therapy (CRRT). Design and setting: Open, prospective clinical study in a multidisciplinary, intensive care unit in a university-affiliated tertiary referral hospital. Patients: Six critically ill patients with acute renal failure on CVVHDE Interventions: Timed blood and ultrafiltrate samples were collected to allow pharmacokinetics and clearances to be calculated of initial and subsequent doses of 200 mg intravenous ciprofloxacin. CVVHD was performed with 1 l/h of dialysate and 2 l/h of predilution filtration solution, producing 3 l/h of dialysis effluent. The blood was pumped at 200 ml/min using a Gambro BMM10 blood pump through a Hospal AN69HF haemofilter. Measurements and results: Ten pharmacokinetic profiles were mea sured. The CVVHDF displayed a urea clearance of 42 ± 3 ml/min, and removed ciprofloxacin with a clearance of 37 ± 7 ml/min. This rate was 2-2.5 greater than previously published for ciprofloxacin in other forms of CRRT. On average the CVVHDF was responsible for clearing a fifth of all ciprofloxacin eliminated (21 ± 10%). The total body clearance of ciprofloxacin was 12.2 ± 4.3 l/h. The trough concentration following the initial dose was 0.7 ± 0.3 mg/l. The area under the plasma concentration time curves over a 24-h period ranged from 21 to 55 mg·h l-1. Conclusions: Intravenous ciprofloxacin 600 mg/day in critically ill patients using this form of CRRT produced adequate plasma levels for many resistant microbes found in intensive care units.
History
Publication title
Intensive Care MedicineVolume
27Issue
4Pagination
665-672ISSN
0342-4642Department/School
School of NursingPublisher
SpringerPlace of publication
United StatesRepository Status
- Restricted