Enteric absorption of ciprofloxacin during the immediate postoperative period.

We studied the enteric absorption of ciprofloxacin immediately following major abdominal surgery to determine if this drug could replace parenteral agents. Nine critically ill subjects received ciprofloxacin, 750 mg, every 12 h for 48 h via nasogastric tube. Drug concentrations were measured after the first and fourth doses. There was insignificant absorption after the initial dose, Cmax = 0.6 +/- 0.6 (mg/L) and AUC0-12 = 3.5 +/- 3.2 (mg.h/L). Unfortunately, serum ciprofloxacin concentrations were also minimally detectable in three of nine subjects after the fourth dose. Enteric absorption of ciprofloxacin, therefore, was erratic and unpredictable in critically ill patients following major abdominal surgery.

Percutaneous transluminal renal angioplasty in patients with renal failure.

Renovascular disease is a common cause of end-stage renal failure in the elderly population. We assessed the role of percutaneous transluminal renal angioplasty in the treatment of patients with renal failure due to renovascular disease by analysing our results in 60 patients treated between 1982 and 1991. All the patients had a baseline serum creatinine level greater than 150 mumol/l; improvement in renal function was defined as a 20 per cent reduction in this level. Seventy-five angioplasty procedures were attempted on 70 arteries in 60 patients. There was an improvement in renal function in 24 patients (40 per cent), whilst six (10 per cent) showed deterioration. The most dramatic improvement was seen in a small group of patients who had suffered an acute deterioration in renal function prior to angioplasty. There was a low incidence of serious complications. Renovascular disease is an important reversible cause of chronic renal failure and should be investigated aggressively so that percutaneous transluminal renal angioplasty can be undertaken in selected patients.