BACKGROUND: The optimal daptomycin dosing regimen for critically ill patients undergoing continuous renal replacement therapy (CRRT) has still to be established. METHODS: Daptomycin pharmacokinetics was determined in 9 patients after administration of 6 mg/kg/day over 5 days. RESULTS: At steady state, which was reached by day 3, the area under the curve over 24 h (AUC24h) was 667.4 ± 356.6 mg·h/l, and the maximum concentration (Cmax) was 66.9 ±25.3 mg/l. Mean CRRT clearance accounted for 48% (range 32-67%) of total clearance (mean 10.2 ml/min, range 6.1-18 ml/min). Significant correlations were observed between Cmax, minimum concentration (Cmin) and AUC24h (R(2) = 0.91, p < 0.001, and R(2) = 0.94, p < 0.001) and between albumin plasma concentration and free daptomycin (R(2) = 0.7, p = 0.009). CONCLUSION: No significant accumulation occurred with a daily daptomycin dose of 6 mg/kg in patients undergoing CRRT with an effluent flow rate of >30 ml/kg/h. The quantification of trough concentrations (Cmin) appears to be a good surrogate to estimate AUC24h and to monitor daptomycin treatment in patients undergoing CRRT.
BACKGROUND: The optimal daptomycin dosing regimen for critically illpatients undergoing continuous renal replacement therapy (CRRT) has still to be established. METHODS:Daptomycin pharmacokinetics was determined in 9 patients after administration of 6 mg/kg/day over 5 days. RESULTS: At steady state, which was reached by day 3, the area under the curve over 24 h (AUC24h) was 667.4 ± 356.6 mg·h/l, and the maximum concentration (Cmax) was 66.9 ±25.3 mg/l. Mean CRRT clearance accounted for 48% (range 32-67%) of total clearance (mean 10.2 ml/min, range 6.1-18 ml/min). Significant correlations were observed between Cmax, minimum concentration (Cmin) and AUC24h (R(2) = 0.91, p < 0.001, and R(2) = 0.94, p < 0.001) and between albumin plasma concentration and free daptomycin (R(2) = 0.7, p = 0.009). CONCLUSION: No significant accumulation occurred with a daily daptomycin dose of 6 mg/kg in patients undergoing CRRT with an effluent flow rate of >30 ml/kg/h. The quantification of trough concentrations (Cmin) appears to be a good surrogate to estimate AUC24h and to monitor daptomycin treatment in patients undergoing CRRT.
Authors: Antonio D'Avolio; Debora Pensi; Lorena Baietto; Giovanni Pacini; Giovanni Di Perri; Francesco Giuseppe De Rosa Journal: Drugs Date: 2016-08 Impact factor: 9.546
Authors: R Andrew Seaton; Francesco Menichetti; Georgios Dalekos; Andres Beiras-Fernandez; Francisco Nacinovich; Rashidkhan Pathan; Kamal Hamed Journal: Adv Ther Date: 2015-11-26 Impact factor: 3.845
Authors: Dominique Breilh; Patrick M Honore; David De Bels; Jason A Roberts; Jean Baptiste Gordien; Catherine Fleureau; Antoine Dewitte; Julien Coquin; Hadrien Rozé; Paul Perez; Rachid Attou; Sebastien Redant; Luc Kugener; Marie-Claude Saux; Herbert D Spapen; Alexandre Ouattara; Olivier Joannes-Boyau Journal: J Transl Int Med Date: 2019-12-31