Pharmacokinetics and dosage adaptation of meropenem during continuous venovenous hemodiafiltration in critically ill patients

Détails

ID Serval
serval:BIB_FB70FDC0E665
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Pharmacokinetics and dosage adaptation of meropenem during continuous venovenous hemodiafiltration in critically ill patients
Périodique
Journal of Clinical Pharmacology
Auteur⸱e⸱s
Robatel  C., Decosterd  L. A., Biollaz  J., Eckert  P., Schaller  M. D., Buclin  T.
ISSN
0091-2700 (Print)
Statut éditorial
Publié
Date de publication
12/2003
Volume
43
Numéro
12
Pages
1329-40
Notes
Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Dec
Résumé
Meropenem, a carbapenem broad-spectrum antibiotic, is regularly used in patients undergoing continuous venovenous hemodiafiltration (CVVHDF). Its disposition was studied over one dosage interval in 15 patients under CVVHDF on a steady regimen of 500 or 1000 mg every 8 to 12 hours. Meropenem levels were measured in plasma and filtrate-dialysate by high-performance liquid chromatography (HPLC) with UV detection. The mean CVVHDF flow rates were 7.1 +/- 0.9 L/h for blood (mean +/- SD), 0.5 +/- 0.3 L/h for predilution solution, 1.2 +/- 0.3 L/h for countercurrent dialysate, and 1.8 +/- 0.5 L/h for the total filtrate-dialysate. The pharmacokinetic analysis was based both on a noncompartmental approach and on a four-compartment modeling. The mean (coefficient of variation [CV]) total body clearance, volume of distribution at steady state, and mean residence time were, respectively, 5.0 L/h (46%), 14.3 L (29%), and 4.8 h (36%). The hemodiafiltration clearances calculated from plasma data alone and plasma with filtrate-dialysate data were 1.2 L/h (26%) and 1.6 L/h (39%), respectively. The compartmental model was used to optimize the therapeutic schedule of meropenem, considering reference minimal inhibitory concentration (MIC) of sensitive strains (4 mg/L). The results indicate that two different therapeutic schedules of meropenem are equally applicable to patients receiving CVVHD: either 750 mg tid or 1500 bid.
Mots-clé
Aged Area Under Curve Critical Care Drug Administration Schedule Female Half-Life *Hemodiafiltration Humans Kidney Failure, Acute/drug therapy/*metabolism/mortality Male Metabolic Clearance Rate Middle Aged Models, Biological Thienamycins/administration & dosage/*pharmacokinetics/therapeutic use
Pubmed
Web of science
Création de la notice
25/01/2008 11:41
Dernière modification de la notice
20/08/2019 17:26
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