Does haemodialysis significantly affect serum linezolid concentrations in critically ill patients with renal failure? A pilot investigation

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
Enrico FiaccadoriAderville Cabassi

Abstract

Previous studies have shown that a single haemodialysis (HD) session removes about one-third of the linezolid dose administered, but it is unknown whether in critically ill patients with renal failure on intermittent HD, this removal adversely affects serum antibiotic concentrations. Five male critically ill patients (mean age 75 years, range 68-82; APACHE II score 26.4, range 23-29; survival 2/5) with sepsis and renal failure on haemodialysis, were administered i.v. linezolid, 600 mg every 12 h. Serum antibiotic levels were measured by high-performance liquid chromatography/mass spectrometry. We classified trough concentrations as 'with HD' when a HD session was performed after linezolid infusion, and 'without HD' otherwise. We also computed population pharmacokinetics while patients were on-dialysis and off-dialysis. A total of 222 serum linezolid concentrations were available over 36 days of antibiotic therapy, during which patients underwent 31 HD sessions. Trough serum linezolid levels averaged 5.83 mg/l (range 1.48-15.84), exceeding 4.0 mg/l in 68.9% of the samples; however, the trough levels 'with HD' were lower than those 'without HD' (4.68 mg/l [range 1.48-9.07] vs 6.74 mg/l [range 2.04-15.84], P<0.001). Clearance and ...Continue Reading

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Citations

Dec 17, 2009·European Journal of Clinical Pharmacology·Stefanie SwobodaMarkus A Weigand
Dec 20, 2008·Current Infectious Disease Reports·Guillaume Dufour, Philippe Montravers
May 6, 2011·The Journal of Antimicrobial Chemotherapy·Matthew S Dryden
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Feb 20, 2009·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Jan T KielsteinOlaf Burkhardt
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May 22, 2019·Antimicrobial Agents and Chemotherapy·Valentina PistolesiEnrico Fiaccadori

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