The pharmacokinetics of cefamandole have been evaluated in five patients undergoing continuous ambulatory peritoneal dialysis (CAPD). The drug was absorbed rapidly from the peritoneum reaching peak serum concentrations averaging 31.3 mcg/ml. Approximately 72% of the dose instilled into the peritoneum was absorbed over a six hour period. Subsequently cefamandole disappeared from the serum slowly with a mean half-life of 10.4 hours. The volume of distribution was 0.25 I/kg. The calculated total body clearance averaged 20.0 ml/min and the mean dialysis clearance was 3.2 ml/min. The authors postulate that in renal failure patients cefamandole may be eliminated by an alternate route.
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References
1.
FongI.W., RalphE.D., EngelkingE.R.Clinical pharmacology of cefamandole as compared with cephalothin.Antimicrob Agents Chemother1976; 9: 65–69.
2.
ShemonskyN.K., CarrizosaJ., LevisonM.E.In vitro activity and pharmacokinetics in patients of cefamandole, a new cephalosporin antibiotic.Antimicrob Agents Chemother1975; 8: 679–683.
3.
MeyersB.R., HirschmanS.Z.Pharmacokinetics of cefamandole in patients with renal failure.Antimicrob Agents Chemother1977; 11: 248–250.
4.
RubinJ., RogersW A., TaylorH.M.Continuous ambulatory peritoneal dialysis.Ann Int Med1980; 92: 7–13.
5.
BechtelT.P., SlaughterR.L., MooreT.D.Seizures associated with high cerebrospinal fluid concentrations of cefazolin.Amer J Hosp Pharm1980; 37: 291.
6.
PastemackD.P., StephensB.G.Reversible nephrotoxicity associated with cephalothin therapy.Arch Int Med1975; 135: 599–602.
7.
MillerK.W., McCoyH.G., ChanK.K.Effect of cardiopulmonary bypass on cefazolin disposition.Clin Pharmacol Ther1980; 27: 550–556.
SomaniP., ShapiroR.S., StockardH.Unidirectional absorption of gentamicin from the peritoneum during continuous ambulatory peritoneal dialysis.Clin Pharmacol Ther1982; 32: 113–121.
10.
PancorboS., ComtyC.Pharmacokinetics of gentamicin in patients undergoing continuous ambulatory peritoneal dialysis.Antimicrob Agents Chemother1981; 19: 605–607.
11.
PancorboS., ComtyC.Peritoneal transport of vancomycin in 4 patients undergoing continuous ambulatory peritoneal dialysis.Nephron1982; 31: 37–39.
12.
GambertoglioJ.G., AzizN.S.Lin ET et al. Cefamandole kinetics in uremic patients undergoing hemodialysis.Clin Pharmacol Ther1979; 26: 592599.
13.
MeyerB.R., RibnerK.B., YamcovitzS., HirschmanS.Z.Pharmacological studies with cefamandole in human volunteers.Antimicrob Agents Chemother1976; 9: 140–144.
14.
GriffithR.S., BlackH.R., BrierG.L.Wolney ill. Cefamandole: In vitro and clinical pharmacokinetics.Antimicrob Agents Chemother1976; 10: 814–823.
15.
BlairD.C., DockD.L., SilbogerS., BomsteinD.L.Serum antimicrobial titers in volunteers and in vitro comparison to cephalothin and cefazolin.Curr Ther Res1977; 22: 861–868.
16.
BodeyG.P., WeaverS.In vitro studies of cefamandole.Antimicrob Agents Chemother1976; 9: 452–457.
17.
EykynS.Jenkins C, King A, Phillips I. Antibacterial activity of cefamandole a new cephalosporin antibiotic. compared with that of cephaloridine. cephalothin, and cephalexin.Antimicrob Agents Chemother1973; 3: 657–661.
