European Journal of Clinical Pharmacology

, Volume 20, Issue 5, pp 371–374 | Cite as

Disposition of Cefoxitin in patients with ascites

  • M. J. Garcia
  • A. Dominguez-Gil
  • F. Diaz Perez
  • F. Perez Rodriguez
  • F. Dominguez Moronta


The pharmacokinetics of Cefoxitin was studied in 8 cirrhotic patients with ascites after i.v. administration of a single 30 mg/kg dose. Concentrations of cefoxitin in serum and in ascitic fluid were determined simultaneously by a microbiologic plate diffusion method. The antibiotic followed a two-compartment open kinetic model. In ascitic fluid, Cefoxitin reached its maximum concentration of 32.80±13,78 µg/ml 2 h after administration. The mean elimination constant from ascitic fluid was 0.201±0.008 h−1, significantly lower (p<0.05) than the slow disposition phase constant (β=0.556±0.17 h−1). At the dose studied and with a dosage interval of 8 h, the level of antibiotic in the ascitic fluid would be maintained at a value greater than the MIC of most cefoxitin-sensitive organisms.

Key words

cefoxitin cirrhosis pharmacokinetics ascites ascitic fluid level 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Barrueco M, Garcia MJ, Otero MJ, Dominguez-Gil A, and Lopez de Letona J (1981) Disposition of Cefoxitin in patients with pleural effusion. Clin Ther 3: 425–435Google Scholar
  2. 2.
    Bergan T (1978) Kinetics of tissue penetration. Scand J Infect Dis suppl 14: 36–46Google Scholar
  3. 3.
    Bourreille J, Lebihan G, Beau B, Leroy A, Humbert (1979) Penetration of Cefoxitin into the ascitic fluid. 11th International Congress of Chemotherapy. Abstract 622Google Scholar
  4. 4.
    Chisholm GD, Smith CB, Water Worth PM, Calnan JS (1976) Factors influencing the distribution of antibacterial agents in interstitial fluid: molecular size and protein binding. Infection 4 (Suppl 2): 5123–5127Google Scholar
  5. 5.
    Fong WL, Jue BW, Nagata EJ (1978) Therapeutic management of cirrhotic ascites. Drug Intell Clin Pharm 2: 534–541Google Scholar
  6. 6.
    Garcia MJ, Dominguez-Gil AA, Cepeda M, Dominguez-Gil A, (1979) Effect of uremia on the distribution of interstitial fluid and biliary excretion of cefoxitin in rabbits FIP 79. Abstract 116. Brighton (England)Google Scholar
  7. 7.
    Garcia MJ, Dominguez-Gil A, Tabernero JM, Sanchez-Tomero JA (1979) Pharmacokinetics of Cefoxitin in patients with normal or impaired renal function. Eur J Clin Pharmacol 16: 1979Google Scholar
  8. 8.
    Garcia MJ, Dominguez-Gi A, Tabernero JM, Bondia Roman A (1979) Pharmacokinetics of Cefoxitin in patients undergoing hemodialisis. Int J Clin Pharmacol 17: 366–370Google Scholar
  9. 9.
    Gerding DN, Kromhout JP, Sullivan JJ, Wendell HH (1976) Antibiotic penetrance of ascitic fluid in Dogs. Antimicrob Agents Chemother 10: 850–855Google Scholar
  10. 10.
    Gerding DN, Hall WH, Schierl EA (1977) Antibiotic concentrations in ascitic fluid of patients with ascites and bacterial peritonitis. Ann Intern Med 86: 708–713Google Scholar
  11. 11.
    Gerding DN, Peterson LR, Salomonson JK, Hall WH, Schierl EA (1978) Prediction of the concentration of penicillins in ascitic fluid from serum kinetics and protein binding of the antibiotics in serum and ascitic fluid of dogs. J Infect Dis 138: 166–173Google Scholar
  12. 12.
    Gill MA, Kern JW (1979) Altered gentamicin distribution in ascitic patients. Am J Hosp Pharm 36: 1704–1706Google Scholar
  13. 13.
    Humbert G, Fillastre JP, Leroy A, Godin M, Van Winzum C (1979) Pharmacokinetics of Cefoxitin in normal subjects and in patients with renal insufficiency. Rev Infect Dis 1: 118–125Google Scholar
  14. 14.
    Lanao JM, Dominguez-Gil A, Macias JG, Diez JL, Nieto MJ (1980) The influence of ascites on the pharmacokinetics of Amikacin. Int J Clin Pharmacol 18: 57–61Google Scholar
  15. 15.
    Morszcazk EJ, Riegelman S (1975) Disposition of dietylstilbestrol in the rhesus monkey. J Pharm Biopharm 3: 303–327Google Scholar
  16. 16.
    Soonneville PF, Skeggs AKS, Gentner H, Kwan KC, Martin CM (1976) Comparative clinical pharmacology of intravenous Cefoxitin and cephalothin. Eur J Clin Pharmacol 9: 397–403Google Scholar
  17. 17.
    Wilson DE, Chalmer TC, Madaff MA (1967) The passage of Cefalotin into and out of ascitic fluid. Am J Med Sci 253: 449–452Google Scholar

Copyright information

© Springer-Verlag 1981

Authors and Affiliations

  • M. J. Garcia
    • 1
  • A. Dominguez-Gil
    • 1
  • F. Diaz Perez
    • 2
  • F. Perez Rodriguez
    • 2
  • F. Dominguez Moronta
    • 2
  1. 1.Practical Pharmacy Department, Faculty of PharmacyUniversity of SalamancaSpain
  2. 2.Medical Pathology Department, Clinical HospitalUniversity of SalamancaSpain

Personalised recommendations