Stea S, Bachelor T, Cooper M, de Souza P, Koenig K, Bolton W K
Department of Internal Medicine, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
J Am Soc Nephrol. 1996 Nov;7(11):2399-402. doi: 10.1681/ASN.V7112399.
This study investigated the disposition and bioavailability of ceftazidime when it was given intraperitoneally. Seven patients were given 1 gm of ceftazidime intravenously, and 1 wk later, the same dose was given intraperitoneally. After both intravenous and intraperitoneal dosing, serum and peritoneal dialysate samples were obtained at set time intervals over a 24-h period. High-performance liquid chromatography was used to determine the ceftazidime concentrations in the serum and dialysate samples. Inspection of the concentration versus time data after intraperitoneal dosing demonstrated that serum ceftazidime concentrations reached therapeutic (> 8 micrograms/mL) levels within 30 min and remained in the therapeutic range for the entire 24-h period. Simulation of a variety of ceftazidime dosing regimens using the mean pharmacokinetic parameters from this population of patients suggests that a regimen of 1.5 gm administered intraperitoneally every 24 h produces trough serum drug concentrations (approximately 40 micrograms/mL) similar to those achieved with a standard regimen of 1.0 gm given intravenously every 24 h in patients undergoing continuous ambulatory peritoneal dialysis. It was concluded that the intraperitoneal dosing of ceftazidime in these patients is an equally effective and a more convenient alternative to its administration.
本研究调查了头孢他啶腹腔内给药后的处置情况和生物利用度。7名患者先静脉注射1克头孢他啶，1周后给予相同剂量进行腹腔内给药。静脉给药和腹腔内给药后，在24小时内按设定的时间间隔采集血清和腹膜透析液样本。采用高效液相色谱法测定血清和透析液样本中的头孢他啶浓度。腹腔内给药后浓度与时间数据检查表明，血清头孢他啶浓度在30分钟内达到治疗水平（>8微克/毫升），并在整个24小时内保持在治疗范围内。使用该患者群体的平均药代动力学参数模拟多种头孢他啶给药方案表明，对于持续非卧床腹膜透析患者，每24小时腹腔内给药1.5克的方案产生的血清药物谷浓度（约40微克/毫升）与每24小时静脉注射1.0克的标准方案相似。得出的结论是，在这些患者中腹腔内注射头孢他啶是一种同样有效且更方便的给药方式。
