Pharmacokinetics of Moxifloxacin and Levofloxacin in Intensive Care Unit Patients Who Have Acute Renal Failure and Undergo Extended Daily Dialysis

Extended daily dialysis (EDD) is increasingly popular in the treatment of acute renal failure (ARF). EDD could remove drugs to a much different degree compared with intermittent standard hemodialysis or continuous renal replacement therapies; however, there are only scarce data on how EDD influences the pharmacokinetics of frequently used drugs. The aim of this study was to determine the pharmacokinetics of two quinolone antibiotics in patients who had anuric ARF and were being treated with EDD. Adult patients who were in the intensive care unit at a tertiary care university hospital and receiving moxifloxacin (n = 10) or levofloxacin (n = 5) therapy were included. The antibiotics were administered intravenously 8 h (400 mg of moxifloxacin) or 12 h (500 mg of levofloxacin) before EDD to study pharmacokinetics off and on EDD. Treatment lasted 8 h; blood and dialysate flow rates were 160 ml/min. In addition to standard pharmacokinetic parameters, the total dialysate concentration of both drugs was measured using a technically simple single-pass batch dialysis system for EDD. Moxifloxacin pharmacokinetics in critically ill patients who had ARF and were undergoing EDD were similar to those in healthy subjects without renal impairment. Levofloxacin, although removed by EDD, had a lower total clearance compared with healthy subjects. According to these findings, anuric critically ill patients who are undergoing EDD should be treated with the standard dosage of moxifloxacin (400 mg/d intravenously). The levofloxacin dosage, however, should be reduced according to the intensity of renal replacement therapy.

Dual in-plane electronic speckle pattern interferometry system with electro-optical switching and phase shifting

A dual in-plane electronic speckle pattern interferometry (ESPI) system has been developed for in situ measurements. The optical setup is described here. The system uses an electro-optical switch to change between the illumination directions for x and y sensitivity. The ability of the electro-optic device to change the polarization of the laser light forms the basis of this switch. The electro-optic device is a liquid-crystal layer cemented between two optically flat glass plates. An electric field can be set up across the layer by application of a voltage to electrodes. The speckle interferometry system incorporates two additional liquid-crystal devices to facilitate phase shifting, and the overall system is controlled by advanced software, which allows switching between the two perpendicular planes in quasi real time. The fact that there are no moving parts is an advantage in any ESPI system for which mechanical stability is vital.