Pharmacokinetics of cefradine, sulfamethoxazole and trimethoprim and their metabolites in a patient with peritonitis undergoing continuous ambulatory peritoneal dialysis |
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Authors: | M Martea Y A Hekster T B Vree A J Voets and J H M Berden |
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Institution: | (1) Department of Clinical Pharmacy, St. Radboud Hospital, P.O. B0X9101, 6500 HB Nijmegen, The Netherlands;(2) Department of Nephrology, St. Radboud Hospital, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands |
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Abstract: | Cefradine and co-trimoxazole pharmacokinetics were studied in a patient with peritonitis that complicated continuous ambulatory peritoneal dialysis (CAPD). Concentrations in the plasma reached after oral administration of 500 mg cefradine four times daily and 400/80 mg co-trimoxazole four times daily were for cefradine 100 g/ml, for trimethoprim 15 g/ml, and for sulfamethoxazole 100 /ml, respectively. In the dialysate concentrations were reached of 35–70 /ml cefradine, 2–5 /ml trimethoprim and 8–17 g/ml sulfamethoxazole. The values for sulfamethoxazole are regarded too low to be clinically effective. Half-lives protein binding values and CAPD clearances are presented. Low CAPD clearances were obtained during the night and high values during the day. The dosage yielded too high plasma trimethoprim concentrations, while sulfamethoxazole dialysate concentrations were too low. It seems questionable therefore whether co-trimoxazole can be used orally for the treatment of CAPD peritonitis. |
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Keywords: | Cefradine Clearance Kidney diseases Metabolism Peritoneal dialysis continuous ambulatory Pharmacokinetics Protein binding Sulfamethoxazole Trimethoprim |
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