• Sven G Guenter, Heiko Iven, Carsten Boos, Hans-Peter Bruch, and Elke Muhl.
• Department of Surgery, Luebeck Medical University, Germany.
• Pharmacotherapy. 2002 Feb 1;22(2):175-83.

Study ObjectiveTo assess the pharmacokinetics of levofloxacin during continuous venovenous hemodiafiltration (CVVHDF) and continuous venovenous hemofiltration (CVVH).DesignNonrandomized pharmacokinetic evaluation.SettingUniversity surgical intensive care unit.PatientsSix critically ill patients.InterventionFive patients received levofloxacin 500 mg/day and one patient received levofloxacin 125 mg/day All patients received continuous renal replacement therapy: CVVHDF on day 1 and CVVH on day 2, using an acrylonitrile hollow-fiber 0.9-m2 filter, constant blood flow rate of 90 ml/minute, substitution flow rate of 1 L/hour predilution, and dialysate flow rate of 1 L/hour (CVVHDF).Measurements And Main ResultsSerum, ultrafiltrate, and dialysate concentrations of levofloxacin were determined by high-performance liquid chromatography. Extracorporeal clearance was 26.05 +/- 4.66 ml/hour during CVVHDF and 15.71 +/- 2.73 ml/hour during CVVH (p<0.05). Elimination half-life was 28.08 +/- 4.5 hours and 45.9 +/- 17.7 hours, and distribution volume was 1.51 +/- 0.52 L/kg and 1.42 +/- 0.42 L/kg for CVVHDF and CVVH, respectively. Saturation was 0.76 +/- 0.13 for CVVHDF versus a sieving coefficient of 0.77 +/- 0.16 for CVVH.ConclusionMarked extracorporeal elimination of levofloxacin occurs, requiring a dosage adjustment that can be calculated from the characteristics of CVVH and CVVHDF.

27 keywords...

hide…