Abstract:
:Prolonged intermittent renal replacement therapy (PIRRT) is an increasingly adopted method of renal replacement in critically ill patients. Like continuous renal replacement therapy, PIRRT can alter the pharmacokinetics (PK) of many drugs. In this setting, dosing data for antibiotics like benzylpenicillin are lacking. In order to enable clinicians to prescribe benzylpenicillin safely and effectively, knowledge of the effects of PIRRT on the plasma PK of benzylpenicillin is required. Herein, we describe the PK of benzylpenicillin in 2 critically ill patients on PIRRT for the treatment of penicillin-susceptible Staphylococcus aureus bacteremia complicated by infective endocarditis. Blood samples were taken for each patient taken over dosing periods during PIRRT and off PIRRT. Two-compartment PK models described significant differences in the mean clearance of benzylpenicillin with and without PIRRT (6.61 vs. 3.04 L/h respectively). We would suggest a benzylpenicillin dose of 1,800 mg (3 million units) every 6-h during PIRRT therapy as sufficient to attain PK/pharmacodynamic target.
journal_name
Chemotherapyjournal_title
Chemotherapyauthors
Cheng V,Rawlins M,Chang T,Fox E,Dyer J,Allen C,Litton E,Page MM,Hoad K,Roberts JAdoi
10.1159/000499375subject
Has Abstractpub_date
2019-01-01 00:00:00pages
17-21issue
1eissn
0009-3157issn
1421-9794pii
000499375journal_volume
64pub_type
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