Pharmacokinetic profiles of intravenous imipenem/cilastatin during slow hemodialysis in critically ill patients.
The pharmacokinetics of imipenem/cilastatin were determined in 7 critically ill patients undergoing slow hemodialysis (HD). All patients were anuric. Following intravenous administration of 500 mg of imipenem/cilastatin, concentrations of the drugs in the serum and dialysate were monitored during slow HD. The elimination phase half-life of imipenem was 3.1 +/- 0.3 h and that of cilastatin was 9.7 +/- 1.2 h. The total body clearance of imipenem and cilastatin was 84.0 +/- 7.2 and 32.2 +/- 2.4 ml/min, respectively. Clearance of imipenem and cilastatin during slow HD was 24.3 +/- 2.4 and 54.3 +/- 3.1%, respectively, of total body clearance. After the 10.5-h session of slow HD, serum concentrations of imipenem and cilastatin were 2.3 +/- 0.4 and 16.0 +/- 1.2 mg/l, respectively. It appears that at least 500 mg of imipenem may be needed as a supplemental dose after a session of slow HD or the application interval should be shortened to maintain a therapeutic concentration.
Kihara
M
M
Second Department of Internal Medicine, Yokohama Minami Kyousai Hospital, Japan.
Ikeda
Y
Y
Shibata
K
K
Masumori
S
S
Ebira
H
H
Shiratori
K
K
Ueda
S
S
Takagi
N
N
Umemura
S
S
Shionoiri
H
H
D000368:Aged; D015377:Cilastatin / Q000008:administration & dosage / Q000493:pharmacokinetics; D000077728:Cilastatin, Imipenem Drug Combination; D016638:Critical Illness; D004338:Drug Combinations; D004341:Drug Evaluation; D004359:Drug Therapy, Combination / Q000008:administration & dosage / Q000493:pharmacokinetics*; D005260:Female; D006207:Half-Life; D006801:Humans; D015378:Imipenem / Q000008:administration & dosage / Q000493:pharmacokinetics; D007262:Infusions, Intravenous; D008297:Male; D006435:Renal Dialysis / Q000379:methods*; D051437:Renal Insufficiency
D004338:Drug Combinations; D015377:Cilastatin; D015378:Imipenem; D000077728:Cilastatin, Imipenem Drug Combination