[Clinical and pharmacokinetic study of pefloxacin in spontaneous ascitic fluid infections]

Abstract

Ten patients with spontaneous ascitic fluid infections received intravenously 400 mg of pefloxacin for pharmacokinetic evaluation of the drug and its diffusion into peritoneal space. The patients were then treated with oral pefloxacin (400 mg every 36 h except for icteric patients: 48 h) during 21 days. Total body clearance was decreased (0.66 +/- 0.16 ml/min/kg) and elimination half life was increased as compared to that observed in normal subject (28.2 +/- 7.6 h), the longest half-lives being observed in the cases with the most severe alteration of hepatic function. Peritoneal concentrations were higher than 1 microgram/ml (i.e. exceeding the minimal inhibitory concentrations for most of the bacterial species involved in ascitic fluid infections) from the first half-hour after infusion to at least 36 hours. 9 of the 10 cases were cured. Pefloxacin provided a well spaced rythm of administration is a suitable antibacterial drug for ascitic fluid infections in cirrhotic patients with two advantages: its effectiveness against Enterobacteriaceae and an oral administration.