Removal and Absorption of Antibiotics in Patients with Renal Failure Undergoing Peritoneal Dialysis

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Abstract
Tetracycline, chloramphenicol, kanamycin and colistimethate were administered to 24 uremic patients undergoing peritoneal dialysis. Of these 4 antibiotics, only kanamycin is removed by peritoneal dialysis in amounts significant enough to dictate major change of the presently accepted dosage schedule. Colistimethate warrants some minor dosage adjustment, although it is less effectively removed than kanamycin. Peritoneal dialysis is ineffective in removing significant amounts of either tetracycline or chloramphenicol. When administered intraperitoneally, both tetracycline and chloramphenicol are rapidly absorbed. This has more significance for tetracycline since the serum half-life of active chloramphenicol does not appear to be significantly altered by renal failure. In contrast, tetracycline half-life is greatly prolonged and toxic serum levels may be rapidly attained and maintained unless a reduced dosage schedule is adopted. Kanamycin and colistimethate were both absorbed when administered intraperitoneally, but in the doses used in this study, not effectively enough to produce therapeutic blood levels.