Summary
The distribution of cefuroxime (250 mg) was studied in patients with renal failure undergoing continuous ambulatory peritoneal dialysis (CAPD). 10 uninfected patients received the drug intravenously and intraperitoneally, while 9 patients with peritonitis were randomly allocated to intravenous or intraperitoneal administration. Samples were taken over the first 6 hour dialysis period. In the infected patients, more drug (p<0.01) crossed into the peritoneal cavity following intravenous injection and reached the systemic circulation following intraperitoneal administration than in the uninfected group. This increased permeability of the peritoneal membrane during infection may result in unexpected systemic toxicity in patients treated with intraperitoneal antibiotics.
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References
Popovich RP, Moncrief EW, Nolph KD, Ghods AJ, Twardowski ZJ, Pyle WK (1978) Continuous ambulatory peritoneal dialysis. Ann Intern Med 88: 449–456
Kurtz SB, Wong VH, Anderson CF, Vogel JP, McCarthy JT, Mitchell JK, Kumar R, Johnson WJ (1983) Continuous ambulatory peritoneal dialysis — Three years' experience at the Mayo Clinic. Mayo Clinic Proc 53: 633–639
Gokal R, Ramos JM, Francis DMA, Ferner RE, Goodship THJ, Proud G, Bint AJ, Ward MK, Kerr DNS (1982) Peritonitis in continuous ambulatory peritoneal dialysis. Lancet 2: 1388–1391
Smith BR, Le Frock JL (1983) Cefuroxime: antimicrobial activity, pharmacology, and clinical efficacy. Ther Drug Monit 5: 149–160
Singlas E, Colin JN, Rottembourg J, Meesen JP, De Martin A, Legrain M, Simon P (1982) Pharmacokinetics of sulphathoxazole-trimethoprim combination during chronic peritoneal dialysis: effect of peritonitis. Eur J Clin Pharmacol 21: 409–415
De Paepe M, Lameire N, Belpaire F, Bogaert M (1983) Peritoneal pharmacokinetics of gentamicin in man. Clin Nephrol 19: 107–109
Walstad RA, Nilsen OG, Berg KJ (1983) Pharmacokinetics and clinical effects of cefuroxime in patients with severe renal insufficiency. Eur J Clin Pharmacol 24: 391–398
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McIntosh, M.E., Smith, W.G.J., Junor, B.J.R. et al. Increased peritoneal permeability in patients with peritonitis undergoing continuous ambulatory peritoneal dialysis. Eur J Clin Pharmacol 28, 187–191 (1985). https://doi.org/10.1007/BF00609690
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DOI: https://doi.org/10.1007/BF00609690