Pharmacokinetics and dosage adaptation of meropenem during continuous venovenous hemodiafiltration in critically ill patients
Details
Serval ID
serval:BIB_FB70FDC0E665
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Pharmacokinetics and dosage adaptation of meropenem during continuous venovenous hemodiafiltration in critically ill patients
Journal
Journal of Clinical Pharmacology
ISSN
0091-2700 (Print)
Publication state
Published
Issued date
12/2003
Volume
43
Number
12
Pages
1329-40
Notes
Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Dec
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Dec
Abstract
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.
Keywords
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
Create date
25/01/2008 11:41
Last modification date
20/08/2019 17:26