The pharmacokinetics of ciprofloxacin in patients with impaired renal function

Abstract

Pharmacokinetics of ciprofloxacin after single oral administration of 250 mg were studied in patients with and without renal failure. Ciprofloxacin concentrations were measured by HPLC. The elimination half-life was 8.7 +/- 0.9 h (mean +/- S.E.M.) in six renal failure patients not on haemodialysis, as compared to 4.4 +/- 0.2 h in six patients with normal renal function. The urinary recovery of unchanged ciprofloxacin was 5.3 +/- 1.7% of dose over 24 h in the renal failure patients, as compared to 37.0 +/- 3.7% in the patients with normal renal function. In haemodialysis patients, the half-life was 5.8 +/- 0.9 h on an interdialysis day, and 3.2 +/- 0.4 h during haemodialysis.

In silico trials using Monte Carlo simulation to evaluate ciprofloxacin and levofloxacin dosing in critically ill patients receiving prolonged intermittent renal replacement therapy

“…The estimated mean fluoroquinolone clearances (55.0 mL/min for ciprofloxacin and 48.3 mL/min for levofloxacin with an effluent rate of 83 mL/min) by PIRRT in the present study Reference flow rate used in this study were higher than those reported (13.3-41.7 mL/min for ciprofloxacin and 11.0-27.6 mL/min for levofloxacin) in CRRT that used lower effluent flows of 17-30 mL/min (Table 5) [30-34, 36, 37]. In contrast, our calculated PIRRT clearances were also lower than those published in IHD with effluent flow rates of 500-600 mL/min [51,52]. The levofloxacin clearance by PIRRT in this present study was similar to the clearance reported in five patients with extended daily dialysis (48.…”

Pharmacokinetics of Levofloxacin and Ciprofloxacin during Continuous Renal Replacement Therapy in Critically Ill Patients

“…Normally, 30 to 50% of ciprofloxacin is eliminated through hepatic metabolism and biliary excretion. It has been demonstrated that ciprofloxacin CL S does not always correlate well with creatinine clearance (1,6,11,23,26), and it has been suggested that increases in biliary clearance may effectively compensate for a reduction in renal clearance in patients with renal impairment (12,13,14). In the present study, 5 of the 10 patients receiving ciprofloxacin also had severe hepatic impairment.…”

“…Total systemic clearance of ciprofloxacin in this patient population was noted to be highly variable, ranging from 0.34 to 1.70 ml/min/kg (compared to 7 to 8 ml/min/kg in patients with normal renal function) (1,6,11,23,26). This could possibly be attributed to variability in nonrenal mechanisms of drug clearance, as well as variations in the efficiency of clearance via CRRT.…”

Pharmacokinetics of Ciprofloxacin in the Elderly

“…In patients with renal dysfunction there was slower elimi nation leading to longer half-life values and an increase in the area under the curve (AUC; 0-24 h) values [Boelaert et al, 1985].…”