PHARMACOKINETICS OF CEFTRIAXONE IN PATIENTS UNDERGOING CONTINUOUS VENOVENOUS HEMOFILTRATION

Continuous hemofiltration is used widely in the management of patients with acute renal failure, but administration guidelines for many drug s have yet to be established. In this study, the pharmacokinetics of c eftriaxone were compared in patients with normal renal function (n = 9 ), mild renal insufficiency (n = 5), and acute renal failure receiving continuous veno-venous hemofiltration (n = 6). Pharmacokinetic parame ters were determined under steady stale conditions. Patients with mild renal insufficiency had a significantly lower renal clearance and lon ger half-life of ceftriaxone; however, drug recovery in the ultrafiltr ate with continuous veno-venous hemofiltration was similar to that in the urine of patients with normal renal function. Pharmacokinetic para meters for renal, nonrenal, and systemic clearance and for volume of d istribution and half-life were also similar between patients receiving continuous veno-venous hemofiltration and those with normal renal fun ction. The sieving coefficient (S) of ceftriaxone (0.69) significantly exceeded the expected free fraction in plasma, confirming previous re ports that protein binding does not limit the sieving of this compound . The results suggest that a reduction in the usual daily dose of ceft riaxone is not required in patients with acute renal failure receiving continuous veno-venous hemofiltration.