Pharmacokinetics of sparfloxacin in continuous ambulatory peritoneal dialysis patients

The pharmacokinetics of sparfloxacin (SPFX) were investigated in continuous ambulatory peritoneal dialysis (CAPD) patients. Doses of 200mg of SPFX were orally administered to 8 CAPD patients after breakfast, and the time-courses of the drug concentration in the plasma, dialysate and urine were monitored by high-performance liquid chromatography. The pharmacokonetic parameters obtained in this study were as follows: Cmax, Tmax, T1/2 and AUC O-∞ were 1.24μg/ml, 5.5hr, 34.0hr and 46.4μg·hr/ml, respectively. The Cmax and Tmax of CAPD patients were not significantly different from those of normal volunteers. However, the T1/2 and AUC O-∞ of the patients, especially who were elderly or had heart disease, were markedly prolonged or increased compared to those of normal volunteers. The recovery rate in dialysate was only 1% within the first 24hr, while the urinary recovery rate in 3 patients was also only 1% within the first 48hr, suggesting that peritoneal and urinary loss for this drug were minimal. In conclusion, although effective and safe concentrations of the drugs were obtained when 200mg of SPFX was orally administered to CAPD patients, its excretion was significantly prolonged. Therefore, drug monitoring is recommended for safe and effective treatment, if administered for a long period.