Cefepime is a broad-spectrum antibiotic used in treating CAPD peritonitis. However, medical knowledge has been lacking with regard to its pharmacokinetic profile after it has been administered intraperitoneally. The current study aims at determining the drug level at different time after the drug has been added into the peritoneal fluid in patients with CAPD peritonitis. The results of this study will finally leads to rational prescription of this drug at correct dosages.

Inclusion Criteria:

• Age >= 18 years & has been put on CAPD for >= 4 weeks before entering into the study

Exclusion Criteria:

• Known hypersensitivity to cefepime or other cephalosporin; CAPD peritonitis <= 28 days before being enrolled into the study
• Antibiotic treatment within 1 week prior to entry into the study
• Severe exit site or tunnel infection on the day of presentation
• Any conditions that prompt early removal of Tenckhoff catheter irrespective of clinical response to antibiotic treatment
• Abdominal malignancy; Any surgical causes of peritonitis
• Suspected or known fungal or tuberculous peritonitis
• History of dementia or known mental incompetency

4 males and 2 females, of age 57.83 +/-11.63 years with urinary creatinine clearance of 0.87+/-2.06ml/min/1.73m2 and admitted for CAPD peritonitis were enrolled. After collection of peritoneal dialysate for cell count and microbiological work-up, all subjects were loaded with 2g cefepime IP and dwelled for 6 hours. This was followed by 250mg cefepime in each subsequent 6-hourly peritoneal dialysis exchange. Plasma cefepime levels were determined at time 0, 1, 2, 4, 8, 12, 16, 24, 48, 72, 96, 120 hrs. Pharmacokinetic analyses were then performed.