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Pharmacokinetics of the antimicrobial agents rifampicin and miconazole released from a loaded central venous catheter

Pharmacokinetics of the antimicrobial agents rifampicin and miconazole released from a loaded central venous catheter

Journal of Hospital Infection 53(2): 129-135, February

The time course of rifampicin and miconazole concentrations after insertion of a polyurethane catheter loaded with these antibiotics were studied. Data from controlled release experiments in vitro were used, and the concentration time courses of the antimicrobials in serum were calculated by pharmacokinetic simulations. Systemic therapy using typical dosages (rifampicin 600 mg/day iv, miconazole 3 X 200 mg/day iv) results in rifampicin concentrations between 54 and 8424 mug/L, and miconazole concentrations between 3567 and 4676 mug/L. After insertion of a polyurethane catheter loaded with these antibiotics, the maximal concentrations after catheter placement were determined as 6 mug/L at 10.7 h for rifampicin, and 13 mug/L at 28.6 h for miconazole. Assuming that the total amount of antibiotics incorporated in the catheter matrix were bioavailable ('worst case'), the resulting maximal concentrations calculated by simulation are 10 mug/L for rifampicin and 65 mug/L for miconazole. Maximal concentrations of rifampicin or miconazole resulting from the insertion of a polyurethane catheter loaded with these antibiotics are, therefore, far below the concentrations resulting from a systemic therapy with the same antimicrobial agents. Even in the worst case, the danger of selecting resistant bacterial strains seems remote because the systemic drug levels are magnitudes of order below subinhibitory concentrations.

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Accession: 011137978

Download citation: RISBibTeXText

PMID: 12586573

DOI: 10.1053/jhin.2002.1358

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