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Pharmacokinetics of cefpirome during continuous venovenous hemofiltration: rationale for an 8-hour dosing interval.

AbstractOBJECTIVE:
Cefpirome is a new semisynthetic cephalosporin, primarily eliminated by the kidneys, that requires dosage adjustment in patients with kidney failure. The optimal dosing regimen of cefpirome in patients with continuous veno-venous hemofiltration (CVVH) is unknown.
METHODS:
Pharmacokinetic properties of cefpirome were investigated in eight anuric patients with acute kidney failure treated by CVVH. All patients received a dosage of 2 g cefpirome every 8 hours after starting the hemofiltration with high-flux polysulfone membranes. Concentrations of cefpirome in plasma and ultrafiltrate were measured by HPLC.
RESULTS:
Total clearance and hemofiltration clearance of cefpirome were 589.1 +/- 164.5 mL/min and 43.3 +/- 7.8 mL/min, respectively. Serum elimination half-life was 2.36 +/- 0.59 hours. The highest plasma drug concentration was 14.8 +/- 3.2 microg/mL, and it declined to trough levels of 3.1 +/- 0.8 microg/mL at the end of the dosing interval.
CONCLUSION:
On the basis of previously published pharmacodynamic characteristics of cefpirome and the pharmacokinetic parameters obtained in this study, we calculated a required total daily dose of 2 g every 8 hours to achieve sufficient plasma antibiotic levels to cover the majority of target pathogens. However, this dosage may be insufficient during CVVH for intermediate resistant strains of Pseudomonas aeruginosa.
AuthorsM Banyai, F Thalhammer, I El-Menyawi, G Heinz, F Traunmüller, P Siostrzonek
JournalClinical pharmacology and therapeutics (Clin Pharmacol Ther) Vol. 67 Issue 4 Pg. 368-72 (Apr 2000) ISSN: 0009-9236 [Print] United States
PMID10801245 (Publication Type: Journal Article)
Chemical References
  • Cephalosporins
  • cefpirome
Topics
  • Acute Kidney Injury (drug therapy, metabolism)
  • Anuria (drug therapy, metabolism)
  • Area Under Curve
  • Cephalosporins (administration & dosage, blood, pharmacokinetics, therapeutic use)
  • Chromatography, High Pressure Liquid
  • Female
  • Half-Life
  • Hemofiltration
  • Humans
  • Intensive Care Units
  • Male
  • Metabolic Clearance Rate
  • Middle Aged

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