Intraperitoneal and intravenous cefoperazone kinetics during continuous ambulatory peritoneal dialysis

Serum cefoperazone (CFP) kinetics after a 1‐gm dose added to the peritoneal dialysate were followed in seven patients undergoing continuous ambulatory peritoneal dialysis (CAPD). In a randomized order five of the seven patients received 1 gm IV CFP. Serum samples were collected over 10 hr during one dialysate exchange interval. CFP concentrations were determined by HPLC. After intravenous dosing CFP mean peak and 6‐hr serum concentrations were 104.2 ± 29.1 µg · ml −1 and 8.5 ± 3.8 µg · ml −1 , mean body clearance was 80 ± 20 ml · min −1 , and mean apparent volume of distribution was 14.6 ±3.2 l. The elimination rate constant (k el ) varied from 0.29 to 0.38 hr −1 and was almost identical to k el derived from intraperitoneal application (range 0.29 to 0.42 hr −1 ). Instillation of CFP with the peritoneal dialysate resulted in a rapid rise of serum levels (T max = 1.9 ±0.7 hr; absorption rate constant k a = 0.68 ± 0.11 hr −1 ), and sufficient CFP concentrations (C max =33.2 ± 5.3 µg · ml −1 ), were maintained over 6 hr (C 6 hr = 17.3 ± 5.8 µg · ml −1 ). Mean systemic availability of intraperitoneal CFP was 95% ± 12%. Intraperitoneal administration of CFP in patients undergoing CAPD resulted in serum levels of CFP adequate for systemic treatment of bacterial infections. Clinical Pharmacology and Therapeutics (1984) 35, 208–213; doi: 10.1038/clpt.1984.28