Chloramphenicol hemodialysis clearance

The purpose of this study was to evaluate the dialysis clearance and plasma protein binding of chloramphenicol in a chronic renal failure patient and an acute renal/hepatic failure patient undergoing hemodialysis. Predialysis, dialysis and postdialysis plasma samples were collected and analyzed. Plasma chloramphenicol levels declined slowly during hemodialysis with measured dialysis clearance rates of 21.2 ml/min (patient C.W.) and 24.2 ml/min (patient S.T.). The protein binding of chloramphenicol, determined before and 30 min after hemodialysis, was 40 and 25% (patient C.W.) and 44 and 35% (patient S.T.), respectively. The extent to which hemodialysis removes chloramphenicol from the plasma does not appear significant enough to warrant routine dosage adjustment. The clinical significance of protein binding alterations is discussed.