Abstract
We examined the pharmacokinetic behavior of 200 mg of ciprofloxacin administered intravenously to 32 volunteers whose renal function as measured by creatinine clearance ranged from 0 to 8.99 liters/h per 1.73 m2. Serum clearances (mean +/- standard deviation) were 26.8 +/- 5.7 and 15.4 +/- 4.3 liters/h per 1.73 m2 in normal and anephric volunteers, respectively. The half-life (mean +/- standard deviation) increased from 4.3 +/- 0.8 h in normal volunteers to 8.6 +/- 3.3 h in anephric volunteers. There was good correlation between normalized creatinine clearance and both normalized serum and renal clearance. The regression equation for serum clearance (CLS) versus creatinine clearance (CLCR) was CLS = 1.97 X CLCR + 13.23, where r = 0.697; for renal clearance versus creatinine clearance, the equation was CLR = 2.26 X CLCR, where r = 0.845. On the basis of these data, we recommend a maximum 50% reduction in dose when ciprofloxacin is instituted at a renal function of 1.2 to 1.8 liters/h per 1.73 m2 (20 to 30 ml/min per 1.73 m2). Because of the observed variation in ciprofloxacin half-life in our anephric volunteers, we also recommend that a schedule of administration every 12 h be maintained, even for patients without urine output.
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Selected References
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- Boelaert J., Valcke Y., Schurgers M., Daneels R., Rosseneu M., Rosseel M. T., Bogaert M. G. The pharmacokinetics of ciprofloxacin in patients with impaired renal function. J Antimicrob Chemother. 1985 Jul;16(1):87–93. doi: 10.1093/jac/16.1.87. [DOI] [PubMed] [Google Scholar]
- D'Argenio D. Z., Schumitzky A. A program package for simulation and parameter estimation in pharmacokinetic systems. Comput Programs Biomed. 1979 Mar;9(2):115–134. doi: 10.1016/0010-468x(79)90025-4. [DOI] [PubMed] [Google Scholar]
- Drusano G. L., Plaisance K. I., Forrest A., Standiford H. C. Dose ranging study and constant infusion evaluation of ciprofloxacin. Antimicrob Agents Chemother. 1986 Sep;30(3):440–443. doi: 10.1128/aac.30.3.440. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Drusano G. L., Standiford H. C., Plaisance K., Forrest A., Leslie J., Caldwell J. Absolute oral bioavailability of ciprofloxacin. Antimicrob Agents Chemother. 1986 Sep;30(3):444–446. doi: 10.1128/aac.30.3.444. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Eliopoulos G. M., Gardella A., Moellering R. C., Jr In vitro activity of ciprofloxacin, a new carboxyquinoline antimicrobial agent. Antimicrob Agents Chemother. 1984 Mar;25(3):331–335. doi: 10.1128/aac.25.3.331. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Shalit I., Greenwood R. B., Marks M. I., Pederson J. A., Frederick D. L. Pharmacokinetics of single-dose oral ciprofloxacin in patients undergoing chronic ambulatory peritoneal dialysis. Antimicrob Agents Chemother. 1986 Jul;30(1):152–156. doi: 10.1128/aac.30.1.152. [DOI] [PMC free article] [PubMed] [Google Scholar]