Peritoneal transport of cefonicid

The pharmacokinetic characteristics of cefonicid, a highly protein-bound expanded-spectrum cephalosporin, were examined in six noninfected, clinically stable patients undergoing continuous ambulatory peritoneal dialysis. After a 1.0-g intravenous dose of cefonicid, the mean concentrations in serum were 105 ± 25 and 35.6 ± 14.4 μg/ml at 3 and 72 h, respectively. Despite a prolonged half-life in serum of 49.7 ± 18 h, the penetration into peritoneal fluid was low. The average concentration in dialysate over the 72-h study period was 2.7 μg/ml. The serum clearance was 2.6 ± 1.0 ml/min, and the distribution volume was 0.14 ± 0.02 liter/kg. Dosage recommendations and clinical considerations for cefonicid use in continuous ambulatory peritoneal dialysis patients are discussed.