Pharmacokinetics of once-daily IP gentamicin in CAPD patients.

Abstract

OBJECTIVE:

This study aimed to investigate the pharmacokinetic characteristics of once-daily intraperitoneal (IP) gentamicin in continuous ambulatory peritoneal dialysis (CAPD) patients.

DESIGN:

Prospective, nonrandomized, open study.

SETTING:

CAPD outpatient clinic in a teaching hospital.

PATIENTS:

Ten volunteer CAPD patients without peritonitis.

INTERVENTIONS:

Each patient received a single IP dose of 0.6 mg/kg of gentamicin. Blood and dialysate samples were collected at 0, 0.5, 1, 2, 3, 6 (end of first dwell), and 24 hours after the administration of IP gentamicin. Any urine produced over the 24-hour study period was also collected. The dialysate concentration/time data were fitted to a monoexponential curve for all patients.

RESULTS:

The bioavailability was 56 +/- 11% over a six-hour dwell. The mean serum elimination half-life (t1/2) was 35.8 hours. The volume of distribution was 0.23 +/- 0.08 L/kg. Equilibration of gentamicin across the peritoneal membrane was rapid, with a t1/2 equilibration of 4.5 hours. The peritoneal clearance was 5.74 +/- 1.5 mL/min. Patients-with residual renal function had significantly higher systemic gentamicin clearances (7.36 +/- 1.46 mL/min) than those of anuric patients (4.76 +/- 1.08 mL/min, p < 0.024).

CONCLUSION:

Currently recommended doses of once-daily IP gentamicin for the treatment of peritonitis may not produce the desired therapeutic serum and dialysate concentrations over 24 hours for effective treatment of peritonitis.

• Authors: C L Low, G R Bailie, A Evans, G Eisele, R A Venezia
• Journal: Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis (Perit Dial Int) 1996 Jul-Aug Vol. 16 Issue 4 Pg. 379-84 ISSN: 0896-8608 [Print] United States
• PMID: 8863331 (Publication Type: Journal Article)

Chemical References

• Gentamicins

Topics

• Adult
• Aged
• Biological Availability
• Drug Administration Schedule
• Female
• Gentamicins (administration & dosage, pharmacokinetics)
• Humans
• Male
• Middle Aged
• Peritoneal Dialysis, Continuous Ambulatory
• Prospective Studies