莫西沙星用于因肾功能受损接受脉冲式高容量血液滤过的危重患者时的药代动力学。

Moxifloxacin is an 8-methoxy quinolone with a broad spectrum of activity against clinically important pathogens. The aim of this study was to investigate the pharmacokinetics of intravenous (i.v.) moxifloxacin in critically ill patients with impaired renal function undergoing pulse high-volumehaemofiltration (PHVHF) (n=8) to provide a reference for clinical rational moxifloxacin use in thesepatients. Blood and ultrafiltrate samples were obtained following i.v. infusion of a single 400mgmoxifloxacin dose. Concentrations of moxifloxacin in serum and ultrafiltrate were determined by HPLC analysis with fluorometric detection. Pharmacokinetics of moxifloxacin in plasma and ultrafiltrate were best described by a two-compartment model. Peak and trough serum moxifloxacinconcentrations were 4.84±1.85mg/L and 1.17±0.73mg/L, respectively, at the arterial port after a single i.v. 400mg dose. The mean elimination half-life was 4.82±2.13h, the volume of distribution was 82.63±24.69L and the calculated AUC_0-12 was 26.91±10.96mgh/L. Total clearance was 14.36±8.44L/h and the clearance of haemofiltration was 1.67±0.95L/h.C_max/MIC₉₀ ratios and predicted AUC_0-24/MIC₉₀ ratios were above the cut-off points for common pathogens that indicate clinical success. A single 400mg i.v. dose of moxifloxacin is safe and efficacious in the treatment ofcritically ill patients infected with clinically common pathogens and impaired renal functionundergoing PHVHF. It also should be kept in mind that the standard dose is not sufficient for this population infected with pathogens with a higher MIC₉₀ (0.5mg/L).