Pharmacokinetics and the optimal regimen for levofloxacin in critically ill patients receiving continuous hemodiafiltration

Takeshi Wada; Masaki Kobayashi; Yuichi Ono; Asumi Mizugaki; Kenichi Katabami; Kunihiko Maekawa; Daisuke Miyamoto; Yuichiro Yanagida; Mineji Hayakawa; Atsushi Sawamura; Ken Iseki; Satoshi Gando

doi:10.1186/s40560-015-0089-0

Pharmacokinetics and the optimal regimen for levofloxacin in critically ill patients receiving continuous hemodiafiltration

J Intensive Care. 2015 May 8;3(1):22. doi: 10.1186/s40560-015-0089-0. eCollection 2015.

Affiliations

¹ Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, N15W7, Kita-ku, Sapporo, 060-8638 Japan.
² Laboratory of Clinical Pharmaceutics & Therapeutics, Division of Pharmasciences, Faculty of Pharmaceutical Sciences, Hokkaido University, N12W6, Kita-ku, Sapporo, 060-0812 Japan.
³ Laboratory of Clinical Pharmaceutics & Therapeutics, Division of Pharmasciences, Faculty of Pharmaceutical Sciences, Hokkaido University, N12W6, Kita-ku, Sapporo, 060-0812 Japan ; Department of Pharmacy, Hokkaido University Hospital, N14W5, Kita-ku, Sapporo, 060-8648 Japan.

Abstract

The aim of this study was to establish the pharmacokinetics of levofloxacin (LVFX) and determine the optimal dose of this drug in critically ill patients receiving continuous hemodiafiltration (CHDF). The results of in vivo and in vitro studies showed the pharmacokinetics of LVFX total clearance (CLtotal) according to the creatinine clearance (CLCre), dialysate flow (QD), and ultrafiltrate flow (QF), to be as follows: CLtotal (l/h) = 0.0836 × CLCre (ml/min) + 0.013 × body weight (kg) + 0.94(QD + QF) (l/h). The optimal dose of LVFX was expressed by the following formula: 50 × CLtotal. These results demonstrate that the usual dose of LVFX (500 mg) was sufficient for the patients evaluated in this study.

Keywords: Clearance; Continuous hemodiafiltration; Levofloxacin; Pharmacokinetics.