NDT Advance Access published online on February 27, 2006
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfl048
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1 Terapia Intensiva, Dipartimento di Clinica Medica, Nefrologia & Scienze della Prevenzione, Università degli Studi di Parma, Italy
* To whom correspondence should be addressed. Background. 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. Methods. 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. Results. 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 half-life were 6.0 l/h and 4.0 h, respectively, while patients were on-dialysis, and 4.4 l/h and 7.3 h, respectively, when they were off-dialysis. Conclusions. HD can significantly reduce serum linezolid levels in critically ill patients with renal failure.
Received July 2, 2005
Accepted January 26, 2006
Brief Report
Does haemodialysis significantly affect serum linezolid concentrations in critically ill patients with renal failure? A pilot investigation
Enrico Fiaccadori 1 *,
Umberto Maggiore 1,
Carlo Rotelli 1,
Roberto Giacosa 1,
Elisabetta Parenti 1,
Edoardo Picetti 2,
Paola Manini 1,
Roberta Andreoli 1,
and
Aderville Cabassi 1
2 Servizio di Anestesia e Rianimazione, Azienda Ospedaliera - Universitaria, Parma, Italy
Enrico Fiaccadori, E-mail: enrico.fiaccadori{at}unipr.it
Abstract 
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  J. T. Kielstein, J. Lorenzen, V. Kaever, H. Burhenne, M. Broll, C. Hafer, and O. Burkhardt Risk of underdosing of ampicillin/sulbactam in patients with acute kidney injury undergoing extended daily dialysis--a single case Nephrol. Dial. Transplant., July 1, 2009; 24(7): 2283 - 2285. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. Burkhardt, C. Hafer, A. Langhoff, V. Kaever, V. Kumar, T. Welte, H. Haller, D. Fliser, and J. T. Kielstein Pharmacokinetics of ertapenem in critically ill patients with acute renal failure undergoing extended daily dialysis Nephrol. Dial. Transplant., January 1, 2009; 24(1): 267 - 271. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Ponticelli New recommendations in the treatment of Gram-positive bacteraemia in dialysis patients Nephrol. Dial. Transplant., January 1, 2008; 23(1): 27 - 32. [Full Text] [PDF]
|
|