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Moxalactam epimer disposition in patients undergoing continuous ambulatory peritoneal dialysis

1985; Wiley; Volume: 38; Issue: 2 Linguagem: Inglês

10.1038/clpt.1985.151

1532-6535

Gene D. Morse, David M. Janicke, Robert Cafarell, Katherine Piontek, Michael A. Apicella, William J. Jusko, J. Joseph Walshe,

Antibiotic Resistance in Bacteria

The kinetics of the epimers of moxalactam (R-MOX, S-MOX) were investigated in patients without infections who were receiving continuous ambulatory peritoneal dialysis after both intravenous and intraperitoneal injections of moxalactam. R-MOX and S-MOX were well absorbed from the peritoneal cavity, with mean systemic availability of 0.71 ± 0.18 and 0.79 ± 0.18, respectively. After intravenous MOX, serum clearance was 10.2 ± 3.4 (R-MOX) and 10.9 ± 3.2 (S-MOX) ml/hr/kg. Net time-averaged peritoneal dialysis clearance of both epimers was minimal, about 10% of serum clearance. Serum and dialysate MOX concentrations were above the minimum inhibitory concentrations for susceptible bacteria for 24 hours after a 2.0 or 1.0 gm intravenous or intraperitoneal dose. Gastrointestinal side effects occurred after a 2.0 gm dose (both intravenous and intraperitoneal) but not after a 1.0 gm dose. There were no significant differences in the kinetics of R-MOX and S-MOX. A single 1.0 gm ip dose leads to serum and dialysate MOX concentrations above the minimum inhibitory concentration for susceptible pathogens for 24 hours. Clinical Pharmacology and Therapeutics (1985) 38, 150–156; doi:10.1038/clpt.1985.151