Pharmacokinetics of Intravenous and Intraperitoneal Ceftazidime in Chronic Ambulatory Peritoneal Dialysis

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Abstract
The pharmacokinetics of ceftazidime have been investigated in eight patients with chronic renal failure undergoing continuous ambulatory peritoneal dialysis. Each subject was given ceftazidime 1 g intravenously and 1 g intraperitoneally at an interval of 1 week. Ceftazidime was assayed by high‐pressure liquid chromatography. After intravenous administration, the pharmacokinetic parameters of ceftazidime were: elimination plasma half‐life (t1/2β) = 24.6 ± 4.6 hours; apparent volume of distribution (Varea): 0.37 ± 0.09 1/kg, total plasma clearance (CL): 11.9 ± 3.3 mL/minute, peritoneal clearance (CLp): 1.7 ± 0.3 mL/minute. Over 72 hours, only 15.6 ± 4.7% of the dose was eliminated by the peritoneal route. After intraperitoneal administration, ceftazidime appeared in the plasma rapidly, and the peak plasma concentration of 24.5 ± 5.2 mg/L was achieved at the fourth hour; the elimination half‐life (t1/2ke) was 20.8 ± 1.7 hours. The absorption of ceftazidime from the peritoneal space was 74.1 ± 7.4%. These data suggest that ceftazidime has bidirectional exchange characteristics through the peritoneal membrane. A single 1‐g intraperitoneal dose led to serum and dialysate concentrations of ceftazidime above the minimum concentrations for susceptible pathogen germs for 24 hours.