Pharmacokinetics of parenteral imipenem/cilastatin in patients on continuous ambulatory peritoneal dialysis

J Antimicrob Chemother. 1991 Feb;27(2):225-32. doi: 10.1093/jac/27.2.225.


We investigated the pharmacokinetics of two intravenous (iv) dose regimens of imipenem/cilastatin in Chinese patients on chronic ambulatory peritoneal dialysis (CAPD), who had an average creatinine clearance of 3.2 ml/min/1.73 m2. Doses of 0.5 and 1.0 g produced mean peak serum imipenem concentrations of 30 and 70 mg/l respectively, about 60% of cilastatin. Peritoneal dialysis fluid (PDF) imipenem concentrations reached 20-30% of the serum peak 4-5 h after iv injection, and the lowest maximum PDF concentrations were 2 mg/l after the 0.5 g dose and 14 mg/l after 1.0 g. Thus both regimes produced PDF imipenem concentrations above the MICs of susceptible pathogens. The half-life of imipenem was 6.4 h and the plasma clearance 66 ml/min; serum and PDF imipenem were in equilibration after about 5 h. Cilastatin had a prolonged half-life of 19 h and a plasma clearance of 10 ml/min, and accumulated in both serum and PDF. With a 0.5 g dose, the pharmacokinetics of imipenem/cilastatin suggest that the combination may prove an effective treatment for peritonitis associated with CAPD.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cilastatin / administration & dosage
  • Cilastatin / blood
  • Cilastatin / pharmacokinetics*
  • Cilastatin, Imipenem Drug Combination
  • Creatinine / metabolism
  • Dialysis Solutions / analysis*
  • Drug Combinations
  • Female
  • Humans
  • Imipenem / administration & dosage
  • Imipenem / blood
  • Imipenem / pharmacokinetics*
  • Infusions, Intravenous
  • Kidney Failure, Chronic / metabolism*
  • Male
  • Metabolic Clearance Rate
  • Middle Aged
  • Peritoneal Dialysis, Continuous Ambulatory*
  • Time Factors


  • Dialysis Solutions
  • Drug Combinations
  • Cilastatin
  • Imipenem
  • Cilastatin, Imipenem Drug Combination
  • Creatinine