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

Détails

ID Serval
serval:BIB_AD543D9502EB
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Institution
Titre
Clindamycin clearance during Cytosorb<sup>®</sup> hemoadsorption: A case report and pharmacokinetic study.
Périodique
The International journal of artificial organs
Auteur(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
Statut éditorial
Publié
Date de publication
05/2019
Peer-reviewed
Oui
Volume
42
Numéro
5
Pages
258-262
Langue
anglais
Notes
Publication types: Case Reports ; Journal Article
Publication Status: ppublish
Résumé
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.
Mots-clé
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
Création de la notice
04/03/2019 14:13
Dernière modification de la notice
20/08/2019 15:17
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