cefoxitin and Kidney-Failure--Chronic

Topics: Anti-Bacterial Agents; Cefoxitin; Clarithromycin; Humans; Kidney Failure, Chronic; Male; Middle Aged; Mycobacterium fortuitum; Mycobacterium Infections, Nontuberculous; Peritoneal Dialysis, Continuous Ambulatory; Peritonitis, Tuberculous

The pharmacokinetics of cefoxitin was studied in patients with renal impairment during haemofiltration and in the intervening periods after administration of 30 and 15 mg/kg of the drug, respectively. Different pharmacokinetic patterns were established during haemofiltration and in the interim period, with average elimination half-lives of 11.85 +/- 4.3 and 3.41 +/- 0.6 h, respectively. The average fraction of the cefoxitin dose eliminated in haemofiltration was 0.62 +/- 0.11, more than that established in haemodialysis. In patients with terminal renal impairment undergoing haemofiltration every 48 h, a dose of 15 or 30 mg/kg is recommended at the start and at the end of each haemofiltration session.

Topics: Blood; Cefoxitin; Humans; Kidney Failure, Chronic; Kinetics; Ultrafiltration

Topics: Adult; Aged; Bacterial Infections; Cefoxitin; Female; Humans; Kidney Diseases; Kidney Failure, Chronic; Male; Middle Aged; Renal Dialysis; Urinary Tract Infections

The pharmacokinetic disposition of 2 g of cefoxitin administered intravenously over 30 min was determined in six patients undergoing continuous ambulatory peritoneal dialysis for chronic renal failure. During the 6-h dialysate dwell time after the drug infusion, the mean apparent volume of distribution for cefoxitin was 0.267 liter/kg (range, 0.201 to 0.325 liter/kg), and the mean elimination t1/2 from plasma was 7.8 h (range, 5.5 to 13.1 h). The peritoneal clearance, averaging 1.51 ml/min (range, 0.58 to 2.35 ml/min), was only 7.4% of the mean plasmas clearance of cefoxitin. Cefoxitin clearance was reduced in patients with renal failure and was not increased by peritoneal dialysis.

Topics: Cefoxitin; Female; Humans; Kidney Failure, Chronic; Kinetics; Male; Peritoneal Dialysis

The parmacokinetics of Cefoxitin were studied after an i.v. administration of 15 mg/kg body weight in 17 patients with terminal renal impairment, 10 of which were undergoing 6 hr hemodialysis sessions. The average pharmokinetic parameters obtained from this kind of patient were the following: alpha = 2.88 hr-1 beta = 0.18 hr-1 K12 = 1.43 hr-1 K21 = 1.04 hr-1 K13 = 0.53 hr-1 Vc = 8.23 l Vp = 11.61 l Vdss = 19.84 l. The amounts of the antibiotic in the central and peripheric compartments are established together with the amount of the antibiotic eliminated as a function of time. The pharmacokinetic parameters are significantly different from those established in the period between dialysis sessions, and thus, the elimination constant reaches a value of 0.28 h-1. The degree of plasma protein binding of Cefoxitin is 41.46% during the hemodialysis sessions. A dosage regimen is programmed as a function of the pharmacokinetic parameters established for this kind of patient. It is recommended that an i.v. dose of 15 mg/kg body weight should be administered at the beginning and end of each dialysis session lasting 6 hours, when the periods between the sessions are 48 hours.

Topics: Adolescent; Adult; Aged; Cefoxitin; Female; Humans; Kidney Failure, Chronic; Kinetics; Male; Middle Aged; Renal Dialysis

The metabolism of cefoxitin, a new semi-synthetic cephamycin antibiotic, in rats with renal insufficiency was examined in comparison with that in control. Ascending urinary tract infection was produced in rats by intra-cystic inoculation with a virulent strain of Escherichia coli. In rats with severe infection progressed into purulent inflammation in the pelvis and medullar and cortical abscess formation, the urinary excretion of the antibiotic was reduced till the first 2 h after an i.v. dose of 40 mg/kg, while its serum levels and biliary excretion during this period were contrarily higher than those in rats with mild infection limited to pelvic inflammation and in control. On the other hand, in rats with renal arteriarctia produced by constriction of the renal artery with silver clip, blood levels of the antibiotic were higher than those in control. In the former animals, the urinary excretion was reduced to about a half, while the biliary excretion was increased up to twofold of that in control through the whole experimental period. In animals either with severe infection or with renal arteriarctia, the total recovery in the urine and the bile during 6 h of the experimental period was almost equal to those in mild infection or control groups.

Topics: Animals; Bile; Blood Urea Nitrogen; Cefoxitin; Cephalosporins; Kidney; Kidney Failure, Chronic; Liver Function Tests; Male; Rats; Time Factors