Clindamycin clearance during Cytosorb hemoadsorption: A case report and pharmacokinetic study.
Details
Serval ID
serval:BIB_C2601E538BC6
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 hemoadsorption: A case report and pharmacokinetic study.
Journal
The International journal of artificial organs
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
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
09/02/2021 10:26
Last modification date
02/03/2022 6:33