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Clinical Sciences |
Department of Nephrology,1 Laikon General Hospital; 4th Department of Internal Medicine,2 University of Athens Medical School, Athens, Greece
Correspondence to: T. Tsaganos, 4th Department of Internal Medicine, Attikon University Hospital, 1 Rimini Str., Athens 124 62, Greece. tsag{at}freemail.gr
Objective: 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.
Patients and Methods: 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.
Results: 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 (AUC0
inf) was
157.95 ± 100.34 mg·hour/L, median t
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 AUC0
24/MIC ratios were above the
cutoff points that indicate clinical success.
Conclusion: 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.
KEY WORDS: Moxifloxacin; pharmacokinetics; renal failure; bacterial peritonitis.
Received 23 January 2008; accepted 26 September 2008.
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