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Journal of Antimicrobial Chemotherapy (1995) 36, 157-163
© 1995 The British Society for Antimicrobial Chemotherapy

research-article

Roxithromycin disposition in patients on continuous ambulatory peritoneal dialysis

Y. W. Francis Lama, John F. Flahertyb, Lucy Yumenac, Patricia Y. Schoenfeldc and John G. Gambertogliob

aDepartment of Pharmacology, University of Texas Health Science Center San Antonio bDivision of Clinical Pharmacy, School of Pharmacy San Francisco, CA, USA cRental Center, Department of Medicine, San Francisco General Hospital, University of California San Francisco, CA, USA

Received 13 October 1994; accepted 24 February 1995

Roxithromycin is a macrolide antibiotic with a spectrum of activity similar to erythromycin. Roxithromycin has been shown to have a favourable pharmacokinetic profile with more reliable absorption and higher, prolonged plasma and tissue concentrations compared with erythromycin. The pharmacokinetics and dialysis clearance of roxithromycin were studied in twelvepatients with end-stage renal disease on continuous ambulatory perionteal dialysis. Following a single 300 mg oral dose, multiple blood, dialysate and urine samples were collected over 48 h and assayed for roxithromycin by a microbiological method. Peak plasma concentrations were attained between 0.5 and 5 h, and ranged from 2.3 to 6.8 mg/L. The mean elimination half-life was 20.6 ± 8.7 h, compared with 10 to 14 h previously reported in healthy volunteers given a single 300 mg dose. Plasma clearance relative to bioavailability (Clp/F) ranged from 37.3 to 118.3 mL/min. The percentage of the dose recovered in the dialysate and net dialysis clearance were low, ranging from 1.0 to3.1% and 0.9 to 1.8 mL/min, respectively. Only 1% of the dose was recovered in the urine. These results demonstrate that roxithromycin is not substantially removed by continuous ambulatory peritoneal dialysis, and its elimination is prolonged in renal failure, possibly due to impaired nonrenal elimination.


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