Pharmacokinetics of intravenous ciprofloxacin for Legionella pneumonia during prolonged intermittent kidney replacement therapy: a case report and literature review
Abstract
Abstract Background Legionella pneumophila is a gram-negative intracellular bacteria that causes pneumonia. In severe cases, combination antimicrobial therapy using azithromycin and ciprofloxacin is recommended and critical care management may be required. Ciprofloxacin requires dose adjustment during kidney replacement therapy; however, dosing guidance during prolonged intermittent kidney replacement therapy (PIKRT) is limited. A population pharmacokinetic (PK) study based on in vitro data suggested high doses would be required to meet pharmacokinetic/pharmacodynamic (PK/PD) targets. Case presentation We describe the PK of intravenous ciprofloxacin in a 71-year-old male with L. pneumophila pneumonia requiring PIKRT. Ciprofloxacin was administered at 400 mg IV every 12 h, in addition to azithromycin. Ciprofloxacin PK modelling described a terminal half-life of 10.7 h and an area under the curve over 24 h (AUC 0-24 ) of 130 mg·h/L. While PK/PD targets specific to L. pneumophila are not established, applying the reported median minimum inhibitory concentration (MIC) for Legionella (0.5 mg/L), and the gram-negative organism PK/PD target AUC 1–24 /MIC > 125, our data supports ciprofloxacin dosing of 400 mg IV every 12 h during PIKRT. Contrary to the prior PK study based on in vitro data, PIKRT did not contribute additional clearance of ciprofloxacin. Conclusions Ciprofloxacin 400 mg IV every 12 h achieved adequate exposure during PIKRT, supporting this dosing regimen for…
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Severe clinical outcomes of COVID-19 associated with proton pump inhibitors: a nationwide cohort study with propensity score matching
- Penicillins for Treatment of Pneumococcal Pneumonia: Does In Vitro Resistance Really Matter?
- Thiophenes—Naturally Occurring Plant Metabolites: Biological Activities and In Silico Evaluation of Their Potential as Cathepsin D Inhibitors
- Inhalable Mannosylated Rifampicin–Curcumin Co-Loaded Nanomicelles with Enhanced In Vitro Antimicrobial Efficacy for an Optimized Pulmonary Tuberculosis Therapy
- Development and validation of microbial bioassay for quantification of Levofloxacin in pharmaceutical preparations
- Association between cord blood 25-hydroxyvitamin D concentrations and respiratory tract infections in the first 6 months of age in a Korean population: a birth cohort study (COCOA)
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.