Gentamicin pharmacokinetics during slow daily home hemodialysis

Manley, Harold J.; Bailie, George R.; McClaran, M.L.; Bender, Walter L.

doi:10.1046/j.1523-1755.2003.00819.x

Cited by 36 publications

(28 citation statements)

References 19 publications

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“…However, these same researchers recently studied daptomycin and a similar ED regimen, and they recommended that daptomycin administration should occur within 8 hours of ED (22). Gentamicin has been studied in ED, and the study suggested dosing immediately after ED (23). Interestingly, it might make more pharmacodynamic sense to administer gentamicin immediately before ED, which has been suggested with IHD (24).…”

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confidence: 99%

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Mueller

Scoville

2012

Clinical Journal of the American Society of Nephrology

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Mueller

Scoville

2012

Clinical Journal of the American Society of Nephrology

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“…Several studies have been performed evaluating gentamicin pharmacokinetics in patients with chronic kidney disease (2)(3)(4), and numerous others have evaluated gentamicin removal by "traditional" hemodialysis, (2,3,(5)(6)(7)(8)(9)(10)(11) newer dialytic techniques (12), and alternative dosing strategies (13)(14)(15)(16). The removal of gentamicin by the dialyzers studied is highly variable across these studies and is due in part to the different types of dialyzers used, length of dialysis sessions, hemodialysis operating characteristics, patient characteristics, delivered Kt/V, etc.…”

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Influence of Hemodialysis on Gentamicin Pharmacokinetics, Removal During Hemodialysis, and Recommended Dosing

Sowinski

Magner

Lucksiri

et al. 2008

Clinical Journal of the American Society of Nephrology

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Background and Objectives: Aminoglycoside antibiotics are commonly used in chronic kidney disease stage 5 patients. The purpose of this study was to characterize gentamicin pharmacokinetics, dialytic clearance, and removal by hemodialysis and to develop appropriate dosing strategies.Design Setting, Participants, and Measurements: Eight subjects receiving chronic, thrice-weekly hemodialysis with no measurable residual renal function received gentamicin after a hemodialysis session. Blood samples were collected serially, and serum concentrations of gentamicin were determined.Results: Median (range) systemic clearance, volume of distribution at steady state, and terminal elimination half-life were 3.89 ml/min (2.69 -4.81 ml/min), 13.5 L (8.7-17.9 L), and 39.4 h (32.0 -53.6 h), respectively. Median (range) dialytic clearance, estimated amount removed, and percent maximum rebound were 103.5 ml/min (87.2-132.7 ml/min), 39.6 mg (19.7-43.9 mg), and 38.7% (0%-71.8%), respectively. Gentamicin dialytic clearance was statistically significantly related to creatinine dialytic clearance (r 2 ‫؍‬ 0.52, P ‫؍‬ 0.04), although this relationship is not likely to be strong enough to serve as a surrogate for gentamicin monitoring. The pharmacokinetic model was used to simulate gentamicin serum concentrations over a one-wk period.Conclusions: In clinical situations where gentamicin is used as the primary therapy in a patient receiving hemodialysis with a CAHP hemodialyzer, conventional doses after each dialysis session are not as efficient at achieving treatment targets as predialysis dosing with larger doses.

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“…For each sample, 3 mL of blood was collected in a lithium heparin tube, pre-filter, at 0, 15, 30, 45,60, 120, 240, 480 and 1440 min (CI only) and post-filter at 30, 120 and 480 min on occasion 1.…”

Section: Sample Collectionmentioning

confidence: 99%

“…For occasion 2, 3 mL of blood was collected in a lithium heparin tube, pre-filter or at arterial line, at 0, 15, 30, 45,60, 120, 240, 480 and post-filter at 480 min. Ultrafiltrate samples were collected and measured at 120, 240, 360 and 480 min, and 3 mL aliquots were kept for analysis.…”

Section: Sample Collectionmentioning

confidence: 99%

“…For each sample, 3 mL of blood was collected in a lithium heparin tube, pre-filter (before the pre-116 filter replacement fluid infusion site), at 0, 15, 30, 45,60, 120, 240, 360 and 1440 min (continuous infusion only) and post-filter (after the post-filter replacement fluid infusion site) at 30, 120 and 360 minutes on occasion 1. On occasion 2, 3 mL of blood was collected at pre-filter, at 0, 15, 30, 45, 60, 120, 240, 360 and post-filter at 360 min.…”

Section: Sample Collectionmentioning

confidence: 99%

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β-lactam antibiotic pharmacokinetics during continuous venovenous haemofiltration in critically ill patients: continuous infusion versus intermittent bolus administration

Jamal¹

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Sepsis is a pathological syndrome that leads to unique physiological changes in critically ill patients, and can affect antibiotic pharmacokinetics. Acute kidney injury (AKI) is common in critically ill patients. The commencement of renal replacement therapy (RRT) in the management of AKI can further affect antibiotic pharmacokinetics. RRT prescription within intensive care units (ICUs) worldwide is highly variable as it depends on availability, speciality and cost. Thus, antibiotic pharmacokinetic studies in RRT derived from one type of RRT are not readily transferrable to another type of RRT. The major challenge caused by RRT is altered antibiotic clearance by the extracorporeal circuit, which will vary depending on the RRT modality and settings. It follows, that standardisation of antibiotic dosing regimens is not advisable. Clinically, when prescribing antibiotic doses for critically ill patients on RRT, various factors require consideration including; RRT mode and settings, patient characteristics (body size and other organ function), and the likely bacterial pathogen susceptibility. Whilst numerous pharmacokinetic studies have been published on various classes of antibiotics to optimize dosing, continuous infusion (CI) as a method to optimise antibiotic activity, has rarely been studied in these patients. Certainly, there has been much recent interest in this alternative mode of administration for beta-lactam antibiotics (e.g penicillin, cephalosporin, carbapenem antibiotics), as a mechanism to achieve sustained antibiotic concentrations in plasma, as well as optimal pharmacokinetic/pharmacodynamics (PK/PD) indices.This Thesis aims to describe the pharmacokinetics of two commonly used beta-lactam antibiotics in intensive care unit (ICU) setting, namely meropenem and piperacilllin/tazobactam during continuous RRT (CRRT) using ex vivo and clinical pharmacokinetic data. Specifically this work will characterise the pharmacokinetics and the probability of PK/PD attainment of beta-lactam dosing by two methods of antibiotic administration, CI and intermittent bolus (IB) in critically ill patients receiving a common form of CRRT, continuous venovenous haemofiltration (CVVH).This Thesis comprises of nine chapters. Chapter one is an introductory chapter where it provides an overview on the literatures on the Thesis topic. The discussion section in Chapter one outlines a theoretical framework behind the objectives of this Thesis, as well as the specific aims of this Thesis.Chapter two incorporates a published review article that systemically analysed the current literatures on different classes of antibiotic pharmacokinetics in special situations in the ICU iii including patients receiving different types of RRT, burn patients and extracorporeal membrane oxygenation (ECMO). This chapter describes the frequency with which current antibiotic dosing regimens achieve the therapeutic targets or the PK/PD targets and outlines alternative dosing strategies that may optimise antibiotic dosing in these populations....

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Gentamicin pharmacokinetics during slow daily home hemodialysis

Cited by 36 publications

References 19 publications

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Influence of Hemodialysis on Gentamicin Pharmacokinetics, Removal During Hemodialysis, and Recommended Dosing

β-lactam antibiotic pharmacokinetics during continuous venovenous haemofiltration in critically ill patients: continuous infusion versus intermittent bolus administration

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