Intraperitoneal and intravenous cefoperazone kinetics during continuous ambulatory peritoneal dialysis

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Abstract
Serum cefoperazone (CFP) kinetics after a 1 g dose added to the peritoneal dialysate were followed in 7 patients undergoing continuous ambulatory peritoneal dialysis (CAPD). In a randomized order 5 of the 7 patients received 1 g i.v. CFP. Serum samples were collected over 10 h during 1 dialysate exchange interval. CFP concentrations were determined by HPLC [high performance liquid chromatography]. After i.v. dosing CFP mean peak and 6-h serum concentrations were 104.2 .+-. 29.1 and 8.5 .+-. 3.8 .mu.g/ml, mean body clearance was 80 .+-. 20 ml/min, and mean apparent volume of distribution was 14.6 .+-. 3.2 l. The elimination rate constant (kel) varied from 0.29-0.38 h-1 and was almost identical to kel derived from i.p. application (range 0.29-0.42 h-1). Instillation of CFP with the peritoneal dialysate resulted in a rapid rise of serum levels (Tmax [time of Cmax] = 1.9 .+-. 0.7 h; absorption rate constant ka = 0.68 .+-. 0.11 h-1), and sufficient CFP concentrations (Cmax [maximum concentration] = 33.2 .+-. 5.3 .mu.g/ml), were maintained over 6 h (C6 h = 17.3 .+-. 5.8 .mu.g/ml). Mean systemic availability of i.p. CFP was 95 .+-. 12%. I.p. administration of CFP in patients undergoing CAPD resulted in serum levels of CFP adequate for systemic treatment of bacterial infections.

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