PDF(Pubmed)
Abstract：
UNASSIGNED: Peritoneal dialysis-related peritonitis (PDRP) presents a significant challenge for nephrologists. Continuous intraperitoneal cefazolin and ceftazidime are recommended for the treatment of peritonitis. However, some pharmacokinetic studies have shown that doses of 15-20 mg/kg/d may not achieve sufficient therapeutic levels. In this study, we investigated the pharmacokinetics of ceftazidime and cefazolin in patients with continuous ambulatory peritoneal dialysis-related peritonitis and compared the pharmacokinetic characteristics between traditional and modified treatment groups.
UNASSIGNED: From February 2017 to December 2019, 42 PDRP patients (17 males, 25 females; mean age: 50.7 ± 12.1 years; mean body weight: 60.9 ± 11.8 kg) were recruited for the study, all participants were anuric. Twenty patients were enrolled in the traditional group and treated with cefazolin (1.0 g) and ceftazidime (1.0 g) via intraperitoneal administration once daily for 14 days. Twenty-two patients were enrolled in the modified group and received the same dose of antibiotics twice daily for the initial five days, followed by once daily for the subsequent nine days. Serum and dialysate samples were collected after days 1, 2, 3, 5, 7, 10, and 14 and analyzed via liquid chromatography-mass spectrometry.
UNASSIGNED: In the traditional group, the highest and lowest serum concentrations of ceftazidime were 35.9 and 21.7 µg/mL, respectively. The highest concentration of cefazolin was 54.6 µg/mL on day 5 and the lowest concentration was 30.4 µg/mL on day 1. In the modified group, the highest and lowest serum concentrations of ceftazidime were 102.2 and 54.8 µg/mL, respectively. The highest concentration of cefazolin was 141.7 µg/mL and the lowest concentration was 79.8 µg/mL. All antibiotic concentrations were above the minimum inhibitory concentration (MIC) level (8 µg/mL of ceftazidime and 2 µg/mL of cefazolin) throughout the treatment period. However, on day 1, the concentration of ceftazidime in the third bag of dialysate effluent from the traditional group fell below the MIC level. Despite remaining above the MIC, cefazolin concentration was consistently lower in the third bag of dialysate effluent from the traditional group throughout the treatment period.
UNASSIGNED: Intraperitoneal administration of cefazolin and ceftazidime at a dose of 1 g twice daily for 5 days and then once daily for the rest of the treatment period ensured adequate therapeutic levels of antibiotics for treating anuric PDRP patients.
UNASSIGNED: From February 2017 to December 2019, 42 PDRP patients (17 males, 25 females; mean age: 50.7 ± 12.1 years; mean body weight: 60.9 ± 11.8 kg) were recruited for the study, all participants were anuric. Twenty patients were enrolled in the traditional group and treated with cefazolin (1.0 g) and ceftazidime (1.0 g) via intraperitoneal administration once daily for 14 days. Twenty-two patients were enrolled in the modified group and received the same dose of antibiotics twice daily for the initial five days, followed by once daily for the subsequent nine days. Serum and dialysate samples were collected after days 1, 2, 3, 5, 7, 10, and 14 and analyzed via liquid chromatography-mass spectrometry.
UNASSIGNED: In the traditional group, the highest and lowest serum concentrations of ceftazidime were 35.9 and 21.7 µg/mL, respectively. The highest concentration of cefazolin was 54.6 µg/mL on day 5 and the lowest concentration was 30.4 µg/mL on day 1. In the modified group, the highest and lowest serum concentrations of ceftazidime were 102.2 and 54.8 µg/mL, respectively. The highest concentration of cefazolin was 141.7 µg/mL and the lowest concentration was 79.8 µg/mL. All antibiotic concentrations were above the minimum inhibitory concentration (MIC) level (8 µg/mL of ceftazidime and 2 µg/mL of cefazolin) throughout the treatment period. However, on day 1, the concentration of ceftazidime in the third bag of dialysate effluent from the traditional group fell below the MIC level. Despite remaining above the MIC, cefazolin concentration was consistently lower in the third bag of dialysate effluent from the traditional group throughout the treatment period.
UNASSIGNED: Intraperitoneal administration of cefazolin and ceftazidime at a dose of 1 g twice daily for 5 days and then once daily for the rest of the treatment period ensured adequate therapeutic levels of antibiotics for treating anuric PDRP patients.
摘要：
■腹膜透析相关性腹膜炎(PDRP)对肾病学家提出了重大挑战。连续腹腔注射头孢唑啉和头孢他啶被推荐用于治疗腹膜炎。然而,一些药代动力学研究表明，15-20mg/kg/d的剂量可能无法达到足够的治疗水平。在这项研究中,我们研究了头孢他啶和头孢唑林在持续性非卧床腹膜透析相关性腹膜炎患者中的药代动力学，并比较了传统和改良治疗组的药代动力学特征。
■从2017年2月到2019年12月，42名PDRP患者（17名男性，25名女性；平均年龄：50.7±12.1岁；平均体重：60.9±11.8kg）被招募用于研究，所有参与者均为无尿症.20例患者纳入传统组，每天一次腹膜内给予头孢唑啉（1.0g）和头孢他啶（1.0g）治疗14天。22名患者被纳入改良组，在最初的五天内每天两次接受相同剂量的抗生素，接下来的九天每天一次。在第1、2、3、5、7、10和14天后收集血清和透析液样品,并通过液相色谱-质谱分析。
■在传统的群体中，头孢他啶的最高和最低血清浓度分别为35.9和21.7µg/mL，分别。第5天头孢唑啉的最高浓度为54.6µg/mL，第1天的最低浓度为30.4µg/mL。在修改后的组中，头孢他啶的最高和最低血清浓度分别为102.2和54.8µg/mL，分别。头孢唑啉的最高浓度为141.7µg/mL，最低浓度为79.8µg/mL。在整个治疗期间，所有抗生素浓度均高于最低抑制浓度（MIC）水平（8µg/mL头孢他啶和2µg/mL头孢唑啉）。然而,在第1天,来自传统组的第三袋透析液流出物中的头孢他啶浓度降至MIC水平以下。尽管保持在MIC之上，在整个治疗期间，传统组的第三袋透析液流出物中的头孢唑林浓度始终较低。
■头孢唑啉和头孢他啶的腹膜给药剂量为1克，每天两次，持续5天，然后在其余的治疗期间每天一次，确保了足够的抗生素治疗水平来治疗尿毒症PDRP患者。
■从2017年2月到2019年12月，42名PDRP患者（17名男性，25名女性；平均年龄：50.7±12.1岁；平均体重：60.9±11.8kg）被招募用于研究，所有参与者均为无尿症.20例患者纳入传统组，每天一次腹膜内给予头孢唑啉（1.0g）和头孢他啶（1.0g）治疗14天。22名患者被纳入改良组，在最初的五天内每天两次接受相同剂量的抗生素，接下来的九天每天一次。在第1、2、3、5、7、10和14天后收集血清和透析液样品,并通过液相色谱-质谱分析。
■在传统的群体中，头孢他啶的最高和最低血清浓度分别为35.9和21.7µg/mL，分别。第5天头孢唑啉的最高浓度为54.6µg/mL，第1天的最低浓度为30.4µg/mL。在修改后的组中，头孢他啶的最高和最低血清浓度分别为102.2和54.8µg/mL，分别。头孢唑啉的最高浓度为141.7µg/mL，最低浓度为79.8µg/mL。在整个治疗期间，所有抗生素浓度均高于最低抑制浓度（MIC）水平（8µg/mL头孢他啶和2µg/mL头孢唑啉）。然而,在第1天,来自传统组的第三袋透析液流出物中的头孢他啶浓度降至MIC水平以下。尽管保持在MIC之上，在整个治疗期间，传统组的第三袋透析液流出物中的头孢唑林浓度始终较低。
■头孢唑啉和头孢他啶的腹膜给药剂量为1克，每天两次，持续5天，然后在其余的治疗期间每天一次，确保了足够的抗生素治疗水平来治疗尿毒症PDRP患者。
