Intraperitoneal penetration of pefloxacin in patients on continuous ambulatory peritoneal dialysis

Summary: Six patients with continuous ambulatory peritoneal dialysis (CAPD) associated peritonitis were treated with oral pefloxacin 400 mg twice a day. the concentration of pefloxacin was assayed in 20 sets of serum and peritoneal dialysate samples taken from these patients. With a mean starting serum level of 7.6 mg/L, pefloxacin was detected in all peritoneal dialysates within 15 min and attained a mean concentration of 4.2 mg/L within 2 h. the percentage penetration of pefloxacin into peritoneal fluid was 72.9% (SD 19.4%). the results showed that the administration of oral pefloxacin 400 mg b.d. could result in peritoneal drug levels that should be adequate for the treatment of peritonitis caused by common pathogens like Enterobacteriaceae species and Staphylococcus aureus. However, it may be necessary to give the drug parenterally on the first day of treatment before steady-state plasma concentrations are achieved and, in empirical therapy, combination antibiotics may be required when infection by more resistant pathogens is suspected.