Ciprofloxacin pharmacokinetic profiles in paediatric sepsis: how much ciprofloxacin is enough?

Lipman, J., Gous, A., Mathivha, L., Tshukutsoane, S., Scribante, J., Hon, H., Pinder, M., Riera-Fanego, J., Verhoef, L. and Stass, H. (2002) Ciprofloxacin pharmacokinetic profiles in paediatric sepsis: how much ciprofloxacin is enough?. Intensive Care Medicine, 28 4: 493-500. doi:10.1007/s00134-002-1212-y


Author Lipman, J.
Gous, A.
Mathivha, L.
Tshukutsoane, S.
Scribante, J.
Hon, H.
Pinder, M.
Riera-Fanego, J.
Verhoef, L.
Stass, H.
Title Ciprofloxacin pharmacokinetic profiles in paediatric sepsis: how much ciprofloxacin is enough?
Journal name Intensive Care Medicine   Check publisher's open access policy
ISSN 0342-4642
1432-1238
Publication date 2002-01-01
Year available 2002
Sub-type Article (original research)
DOI 10.1007/s00134-002-1212-y
Open Access Status
Volume 28
Issue 4
Start page 493
End page 500
Total pages 8
Place of publication Berlin
Publisher Springer Berlin / Heidelberg
Language eng
Subject 110310 Intensive Care
Abstract Objective: To determine the pharmacokinetic profile of ciprofloxacin 20 mg/kg per day (10 mg/kg administered intravenously 12 hourly) in paediatric patients with severe sepsis. Design: Open and prospective. Setting: Tertiary referral multi-disciplinary ICU. Patients: Twenty patients (two groups - group A: 3 months-1 year; group B 1-5 years). Interventions: Timed blood samples were taken for pharmacokinetics after the first dose (D0), as well as day 2 (D2) and then between days 6-8. Measurements and results: Ciprofloxacin serum levels were measured by high performance liquid chromatograghy. Demographic and clinical data and all adverse events were noted. Standard pharmacokinetic variables were calculated by non-compartmental methods. Peak concentrations (Cmax) for group A were D0 6.1-1.2 mg/l, D2 9.0-1.8 mg/l and D7 5.8-1.3 mg/l and, for group B, 7.4-1.3 mg/l, 7.8-1.6 mg/l and 6.4-1.3 mg/l, respectively, for the study periods. Concentration 12 h after the start of infusion (Cmin) for all periods were 0.2 mg/l or less. Areas under the curve (AUC, 12 h) were group A: 15.6-1.3, 19.2-1.63 and 14.1-1.4 mg/h per l, and group B: 15.9-1.3, 18.0-1.7 and 13.2-1.26 mg/h per l. One patient presenting with seizures, initially controlled, had another convulsion and a further patient developed seizures whilst on ciprofloxacin. Cmax in these patients were higher than the average Cmax. The convulsions of both patients were easily controlled. No other drug-related serious adverse events occurred. No arthropathy was noted. Three patients died of their underlying disease. Conclusions: There was no accumulation of drug even after 7 days of administration. Our Cmax and AUC were lower than that achieved in a similar adult pharmacokinetic study. To achieve end points of area under the inhibitory curve (AUIC) of 100-150 mg/h per l, 10 mg/kg ciprofloxacin eight hourly would be required for some resistant ICU organisms.
Keyword Critical Care Medicine
General & Internal Medicine
CRITICAL CARE MEDICINE
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
 
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Created: Thu, 19 Mar 2009, 21:00:26 EST by Ms Sarada Rao on behalf of Anaesthesiology and Critical Care - RBWH