Journal of Antimicrobial Chemotherapy (1987) 20, 69-76
© 1987 The British Society for Antimicrobial Chemotherapy
research-article |
Multiple dose pharmacokinetics of intravenous acyclovir in patients on continuous ambulatory peritoneal dialysis
Algemeen Ziekenhuis St.-Jan Brugge, Belgium aWellcome Research Laboratories Beckenham, Kent, England
accepted 5 January 1987
Reprints and correspondence: Dr. B. C. Weatherley, Wellcome Research Laboratories, Beckenham, Kent, England
Once daily 60 min iv infusions of acyclovir at 2.5 mg/kg were administered to six uraemic patients (three male, three female of mean age 52 years and body weight 60 kg) treated by continuous ambulatory peritoneal dialysis (CAPD). Blood and dialysate samples were taken for analysis of acyclovir by radio-immunoassay. A three-compartment pharmacokinetic model was found necessary to explain the profiles obtained. Steady-state was reached by the third day, with little change in mean peak or trough plasma levels between day one (25 and 3µM) and day five (29 and 4 µM). Mean total plasma clearance was 46 ml/h/kg, of which 12% was due to peritoneal dialysis. The model parameters predicted efficient transfer of acyclovir from the peritoneum to plasma, such that hypothetical peritoneal dosing might give 91% bioavailability. In patients treated by CAPD, iv acyclovir should be administered at 2.5 mg/kg/day.