The Clearance of Antibiotics by the Artificial Kidney

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Abstract
This study was undertaken to determine the effect of haemodialysis on the clearance of antibiotics from blood in an isolated kidney circuit. Blood, plasma and saline were propelled into the dialyser by a roller pump. Antibiotics (amoxycillin, flucloxacillin, kanamycin, gentamycin, erythromycin, lincomycin and cephalothin) were injected into the arterial tubing. The concentrations of the antibiotics were determined in samples taken from the venous tubing. The clearance of the antibiotics was calculated from their disappearance curves. The calculated clearances in blood show a wide variation (minimal 6.9 ml/min for flucloxacillin in contrast to maximal 52.0 ml/min for amoxycillin). These differences are most likely due to protein binding as there was no significant difference in clearances if saline was used instead of blood. The rate of clearance seems to be determined by the dissociation of the reversible protein binding.

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