Clindamycin clearance during Cytosorb<sup>®</sup> hemoadsorption: A case report and pharmacokinetic study.

Details

Serval ID
serval:BIB_AD543D9502EB
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Clindamycin clearance during Cytosorb<sup>®</sup> hemoadsorption: A case report and pharmacokinetic study.
Journal
The International journal of artificial organs
Author(s)
Poli E.C., Simoni C., André P., Buclin T., Longchamp D., Perez M.H., Ferry T., Schneider A.G.
ISSN
1724-6040 (Electronic)
ISSN-L
0391-3988
Publication state
Published
Issued date
05/2019
Peer-reviewed
Oui
Volume
42
Number
5
Pages
258-262
Language
english
Notes
Publication types: Case Reports ; Journal Article
Publication Status: ppublish
Abstract
Panton-Valentine leucocidin producing methicillin-resistant Staphylococcus aureus infections are rare but associated with very high mortality rates. We report the case of a 14-year-old patient with Panton-Valentine leucocidin producing methicillin-resistant Staphylococcus aureus infection and Influenza B pneumonia requiring veno-arterial extra-corporeal membrane oxygenator for refractory shock. In the absence of response to conventional therapy, we have inserted a Cytosorb® cartridge within the extra-corporeal membrane oxygenator circuit. A spectacular decrease in vasopressor requirements followed. Since clindamycin, a key component of Panton-Valentine leucocidin producing methicillin-resistant Staphylococcus aureus treatment, might be removed by Cytosorb® hemoadsorption, we have performed serial plasma concentrations measurements of the drug. Based on these measurements, we were able to develop a pharmacokinetic model incorporating variable plasma clearance. Patient's exposure was estimated before, during and after Cytosorb® hemoadsorption. According to this model, Cytosorb® hemoadsorption did not seem to result in significant clindamycin removal. Cytosorb® hemoadsorption during Panton-Valentine leucocidin producing methicillin-resistant Staphylococcus aureus infection appears safe and feasible and no adaptation of clindamycin dosage seems necessary.
Keywords
Adolescent, Anti-Bacterial Agents/administration & dosage, Anti-Bacterial Agents/pharmacokinetics, Clindamycin/administration & dosage, Clindamycin/pharmacokinetics, Exotoxins/blood, Extracorporeal Membrane Oxygenation/methods, Hemoperfusion/methods, Humans, Leukocidins/blood, Male, Metabolic Clearance Rate, Methicillin-Resistant Staphylococcus aureus/drug effects, Methicillin-Resistant Staphylococcus aureus/isolation & purification, Sorption Detoxification/methods, Staphylococcal Infections/complications, Staphylococcal Infections/microbiology, Staphylococcal Infections/physiopathology, Staphylococcal Infections/therapy, Staphylococcus aureus/isolation & purification, Staphylococcus aureus/pathogenicity, Adsorbents, antibiotics, apheresis & detoxification techniques, artificial kidney, hemoperfusion, infection, paediatric ECMO, plasma clearance, sepsis, treatment of bacterial infections
Pubmed
Web of science
Create date
04/03/2019 15:13
Last modification date
20/08/2019 16:17
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