Objective: To study the effect of continuous veno-venous hemofiltration (CVVHF) on the pharmacokinetics of levofloxacin in critically ill patients with acute renal failure.
Design: Open-label study.
Setting: Anesthesiology ICU, University Hospital of Regensburg.
Patients: Six critically ill patients treated with CVVHF because of acute renal failure needing antimicrobial therapy.
Interventions: Levofloxacin i.v. 250 mg qd with a starting dose of 500 mg. CVVHF with the following characteristics: hemofilter AN69 hollow fibers of 0.90 m2 area, blood flow 150 ml/min, ultrafiltrate flow 1.3 l/h, filtrate substitution in post-dilution mode.
Measurements And Results: The plasma pharmacokinetics and clearance of levofloxacin by hemofiltration were established on day 1 and day 4-6 of treatment. Levofloxacin was determined by high-performance liquid chromatography (HPLC). Mean (range) peak plasma concentrations after levofloxacin 500 mg single dose (s.d.) and 250 mg multiple dose (m.d.) were 6.4 (2.7-9.4) and 8.2 (4.7-10.3) mg/l, trough levels 2.7 (1.4-5.0) and 2.9 (1.7-3.9) mg/l, half-life 28 (19-38) and 22 (17-31) h, volume of distribution 1.2 (0.72-1.6) l/kg and 0.91 (0.52-2.0) l/kg, respectively. The mean sieving coefficient was 0.96 (0.79-1.09), mean total clearance 47 (20-89) ml/min, and mean clearance by hemofiltration 21 (13-27) ml/min, respectively.
Conclusions: A dosage schedule of levofloxacin 250 mg qd with a 500 mg loading dose seems appropriate for anuric patients during CVVHF. Sufficiently high steady-state concentrations of levofloxacin were achieved after the first dose. Undesired accumulation of levofloxacin was not observed.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s001340000836 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The application of design of experiments and artificial neural networks in the evaluation of the impact of acidic conditions on cloud point extraction.
J Chromatogr A
January 2025
Department of Physical Pharmacy and Pharmacokinetics, Poznań University of Medical Sciences, Rokietnicka 3 Street, Poznań 60-806, Poland. Electronic address:
This study aimed to analyze the impact of acidic conditions on the recovery of ciprofloxacin and levofloxacin for cloud point extraction with the Design of Experiments and Artificial Neural Networks. The design included 27 experiments featuring three repetitions of the central point for both drugs. The tested parameters included Triton X-114 concentration, HCl concentration, NaCl concentration, and incubation temperature, which were coded at five levels.
View Article and Find Full Text PDFDevelopment of novel broad-spectrum amphipathic antimicrobial peptides against multidrug-resistant bacteria through a rational combination strategy.
J Adv Res
January 2025
State Key Laboratory of National Security Specially Needed Medicines, Beijing Institute of Pharmacology and Toxicology, Beijing 100850, China. Electronic address:
Introduction: In recent years, cationic amphipathic antimicrobial peptides (AMPs) have shown great promise in combating antibiotic resistance on account of their distinctive membrane-disruptive mechanism. However, the clinical application of AMPs is restricted by their unsatisfactory stability and safety. Although attempts have been made to improve the stability and safety of AMPs, many of them are accompanied by a decline in their antimicrobial activity and bacterial selectivity.
View Article and Find Full Text PDFDevelopment and validation of an LC-MS/MS multiplex assay for the quantification of bedaquiline, n-desmethyl bedaquiline, linezolid, levofloxacin, and clofazimine in dried blood spots.
J Chromatogr B Analyt Technol Biomed Life Sci
January 2025
Dried blood spot (DBS) assays to quantify novel and repurposed drugs for the treatment of rifampicin-resistant tuberculosis (RR-TB) would facilitate pharmacokinetic studies and therapeutic drug monitoring in low-middle income settings, considering their ease of application and simple sample storage requirements. We describe a DBS method for the simultaneous quantification of bedaquiline and metabolite N-desmethyl bedaquiline, linezolid, levofloxacin, and clofazimine. The analytes were extracted from the matrix and isolated by solid-phase extraction.
View Article and Find Full Text PDFFluoroquinolones and rifampin combination in the backdrop of heteroresistant tuberculosis.
Antimicrob Agents Chemother
January 2025
Division of Infectious Diseases, Department of Medicine, University of Texas at Tyler School of Medicine, Tyler, Texas, USA.
The impact of heteroresistance on tuberculosis (TB) treatment outcomes is unclear, as is the role of different rifampin and isoniazid exposures on developing resistance mutations. Hollow fiber system model of TB (HFS-TB) units were inoculated with drug-susceptible () and treated with isoniazid and rifampin exposure identified in a clinical trial as leading to treatment failure and acquired drug resistance. Systems were sampled for drug concentration measurements, estimation of total and drug-resistant , and small molecule overlapping reads (SMOR) analysis for the detection of heteroresistance.
View Article and Find Full Text PDFThe Effect of Fluoroquinolones on Aortic Aneurysm and Dissection.
Cureus
November 2024
Vascular Surgery, University of Colorado Anschutz Medical Center, Colorado, USA.
Fluoroquinolones (FQs) are a widely prescribed class of antibiotics including ciprofloxacin, levofloxacin, and ofloxacin. They are commonly used to treat a variety of infections worldwide. Known for their broad-spectrum antimicrobial activity, as well as excellent pharmacokinetics and bioavailability, the use of FQs has risen significantly.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!