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  • Pharmacokinetics of ciprofloxacin in ICU patients on continuous veno-venous haemodiafiltration.

    Author(s)
    Wallis, SC
    Mullany, DV
    Lipman, J
    Rickard, CM
    Daley, PJ
    Griffith University Author(s)
    Rickard, Claire
    Year published
    2001
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    Abstract
    Objectives: To investigate the pharmacokinetics of intravenous ciprofloxacin 200 mg every 8 h in critically ill patients on continuous veno-venous haemodiafiltration (CVVHDF), one form of continuous renal replacement therapy (CRRT). Design and setting: Open, prospective clinical study in a multidisciplinary, intensive care unit in a university-affiliated tertiary referral hospital. Patients: Six critically ill patients with acute renal failure on CVVHDF. Interventions: Timed blood and ultrafiltrate samples were collected to allow pharmacokinetics and clearances to be calculated of initial and subsequent doses of 200 mg ...
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    Objectives: To investigate the pharmacokinetics of intravenous ciprofloxacin 200 mg every 8 h in critically ill patients on continuous veno-venous haemodiafiltration (CVVHDF), one form of continuous renal replacement therapy (CRRT). Design and setting: Open, prospective clinical study in a multidisciplinary, intensive care unit in a university-affiliated tertiary referral hospital. Patients: Six critically ill patients with acute renal failure on CVVHDF. Interventions: Timed blood and ultrafiltrate samples were collected to allow pharmacokinetics and clearances to be calculated of initial and subsequent doses of 200 mg intravenous ciprofloxacin. CVVHD was performed with 1 l/h of dialysate and 2 l/h of predilution filtration solution, producing 3 l/h of dialysis effluent. The blood was pumped at 200 ml/min using a Gambro BMM-10 blood pump through a Hospal AN69HF haemofilter. Measurements and results: Ten pharmacokinetic profiles were measured. The CVVHDF displayed a urea clearance of 42±3 ml/min, and removed ciprofloxacin with a clearance of 37±7 ml/min. This rate was 2–2.5 greater than previously published for ciprofloxacin in other forms of CRRT. On average the CVVHDF was responsible for clearing a fifth of all ciprofloxacin eliminated (21±10%). The total body clearance of ciprofloxacin was 12.2±4.3 l/h. The trough concentration following the initial dose was 0.7±0.3 mg/l. The area under the plasma concentration time curves over a 24-h period ranged from 21 to 55 mg·h l–1. Conclusions: Intravenous ciprofloxacin 600 mg/day in critically ill patients using this form of CRRT produced adequate plasma levels for many resistant microbes found in intensive care units.
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    Journal Title
    Intensive Care Medicine
    Volume
    27
    Issue
    4
    DOI
    https://doi.org/10.1007/s001340100857
    Subject
    Clinical Sciences
    Public Health and Health Services
    Publication URI
    http://hdl.handle.net/10072/60697
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