Vancomycin pharmacokinetics in critically ill patients receiving continuous haemodiafiltration with a polyethyleneimine‐coated polyacrylonitrile membrane. (4th June 2020)

• Record Type: Journal Article
• Authors: Tsuruyama, Moeko; Yamashina, Takuya; Tsuruta, Minako; Tsukada, Hiroko; Fujimoto, Airi; Nagano, Masahisa; Kawamata, Yosei; Takashima, Shinya; Hiraki, Yoichi
• Is Part Of: Journal of clinical pharmacy and therapeutics. Volume 45:Number 5(2020)
• Page Start: 1143
• Page End: 1148
• Publication Date: 2020-06-04
• Subjects: AN69ST -- clearance -- continuous haemodiafiltration -- pharmacokinetics -- vancomycin; Clinical pharmacology -- Periodicals; Chemotherapy -- Periodicals; 615
• DOI: 10.1111/jcpt.13197
• Languages: English
• ISSNs: 0269-4727

Abstract

Abstract: What is known and objective: We investigated the elimination efficiency and pharmacokinetics (PK) parameters of vancomycin (VCM) in patients undergoing continuous haemodiafiltration (CHDF) using a polyethyleneimine‐coated polyacrylonitrile membrane (AN69ST) for dosage adjustment. Methods: We conducted a retrospective study of CHDF patients treated with VCM from December 2017 to August 2019. We calculated PK parameters of VCM and determined the 24‐hour dose required to maintain the target trough concentration of VCM (VCM_trough ). Results and discussion: The average (95% CI) volume of distribution and total clearance of VCM were 75.5 L (63.7‐87.3 L) and 1.84 L/h (1.38‐2.30 L/h), respectively, and the elimination rate constant and half‐life were 0.026/h (0.017‐0.034/h) and 31.2 h (22.8‐39.5 h), respectively. The average AN69ST clearance of VCM (CL_CHDF ) was 0.69 L/h (0.52‐0.86 L/h). The estimated average doses required to maintain VCM_trough of 10, 15 and 20 μg/mL were 623.1 mg (379.8‐866.4 mg), 934.6 mg (569.7‐1299.5 mg) and 1246.2 mg (759.6‐1732.8 mg), respectively. What is new and conclusion: The PK of VCM and CL_CHDF of AN69ST were clarified. These results suggest that it is possible to adjust the dose of VCM in using AN69ST, which efficiently removes cytokines, and contributes to improvement of serious infections. Abstract : This study showed pharmacokinetics of vancomycin in patients undergoing CHDF using AN69ST and estimated the 24‐hour dose required to maintain the target trough concentration of vancomycin.