Multiple-dose pharmacokinetics of cefepime in long-term hemodialysis with high-flux membranes

Objective: Among uremic patients on hemodialysis, infectious complications leading to a high incidence of morbidity and mortality are a well-documente d problem. In this multi-dose study, the safety, tolerance, and pharmacokin etics of cefepime during high-flux hemodialysis were investigated and an im proved dosing schedule is presented. Methods: Six long-term hemodialysis patients received 2 g cefepime i.v. at the end of hemodialysis three times per week. Results: Trough levels of cefepime were 23.3 +/- 7.3 mg/l and peak serum co ncentrations 165.6 +/- 48.7 mg/l. After 3.5 h of high-flux hemodialysis, 72 .2 +/- 6.4% of cefepime was eliminated. The intradialytic half-life was 1.6 +/- 0.29 h and the interdialytic half-life 22.0 +/- 2.14 h. Conclusion: A dosage of 2 g cefepime after each hemodialysis session achiev ed drug levels well above the minimal inhibitory concentration (MIC)(90) fo r most of the target pathogens. Thus, the described dosing schedule is an e fficient and cost saving antmicrobial therapy for severe infections in long -term hemodialysis patients with no residual renal function.