Elimination of meropenem during continuous veno-venous haemofiltration and haemodiafiltration in patients with acute renal failure.
Meropenem elimination was studied in six patients with acute renal failure on continuous venovenous haemofiltration (CVVH) or continuous veno-venous haemodiafiltration (CVVHDF) 1 L/h and 2 L/h for 12 h. Meropenem 1 g was given iv over three dialysis periods, and plasma, ultrafiltrate/dialysate and urine concentrations of meropenem were determined. The half-life of meropenem was significantly longer (P < 0.05) during CVVH (7.5 +/- 2.0 h; mean +/- S.D.) than during CVVHDF 1 L/h (5.6 +/- 1.4 h) or 2 L/h (4.8 +/- 1.2 h). Meropenem clearance was 3.27 +/- 2.30 L/h, 4.72 +/- 2.69 L/h and 5.71 +/- 3.58 L/h in CVVH, CVVHDF 1 L/h and CVVHDF 2 L/h, respectively (P < 0.05 between CVVH and CVVHDF). Patients with renal failure on CVVHDF 1 or 2 L/h should be treated with meropenem 1 g bid; 500 mg tid may be enough for patients on CVVH.
Valtonen
M
M
Department of Medicine, Division of Infectious Diseases and Nephrology, Helsinki University Central Hospital, Helsinki, Finland. matti.valtonen@huch.fi
Tiula
E
E
Backman
J T
JT
Neuvonen
P J
PJ
D058186:Acute Kidney Injury / Q000628:therapy*; D000328:Adult; D000368:Aged; D005260:Female; D017583:Hemodiafiltration; D006440:Hemofiltration; D006801:Humans; D008297:Male; D000077731:Meropenem; D008875:Middle Aged; D013845:Thienamycins / Q000493:pharmacokinetics* / Q000627:therapeutic use
D013845:Thienamycins; D000077731:Meropenem