Manley Harold J, Bailie George R
University of Missouri - Kansas City, School of Pharmacy, Kansas City, Missouri 64108, USA.
Semin Dial. 2002 Nov-Dec;15(6):418-21. doi: 10.1046/j.1525-139x.2002.00103.x.
Clinicians treating peritoneal dialysis (PD)-associated peritonitis should be aware that continuous ambulatory PD (CAPD) and automated PD (APD) have different effects on the pharmacokinetics of antibiotics. Results from various APD and comparative CAPD pharmacokinetic studies are reviewed. In APD patients, antibiotic half-lives were shorter during the cycler exchanges. Antibiotic peritoneal clearance was greater in patients treated with APD than those treated with CAPD regimens. Antibiotic clearance depends upon residual renal function and dialysate flow rate. To ensure that maximal antibiotic bioavailability occurs with intermittent intraperitoneal (IP) dosing, it is recommended that the antibiotic-containing dialysate must dwell at least 4 hours to ensure an adequate antibiotic depot in the body. Knowledge of antibiotic disposition in PD patients will assist clinicians in appropriate IP antibiotic dose selection and prevention of dose-related adverse effects.
治疗腹膜透析（PD）相关腹膜炎的临床医生应意识到，持续非卧床腹膜透析（CAPD）和自动化腹膜透析（APD）对抗生素的药代动力学有不同影响。本文综述了各种APD和CAPD药代动力学对比研究的结果。在APD患者中，循环器交换期间抗生素半衰期较短。接受APD治疗的患者抗生素腹膜清除率高于接受CAPD方案治疗的患者。抗生素清除率取决于残余肾功能和透析液流速。为确保间歇性腹腔内（IP）给药时抗生素达到最大生物利用度，建议含抗生素的透析液必须留存至少4小时，以确保体内有足够的抗生素储备。了解PD患者体内抗生素的处置情况将有助于临床医生合理选择IP抗生素剂量并预防剂量相关的不良反应。
