Clearance of ceftazidime during continuous venovenous haemofiltration in critically ill patients.
Published recommendations for the optimal dosing regimen of ceftazidime in critically ill patients with continuous venovenous haemofiltration (CVVH) differ. The aim of this prospective study was to analyse the pharmacokinetic and pharmacodynamic parameters of ceftazidime during CVVH with a high-flux polysulphone membrane, and derive a dosage recommendation. Twelve critically ill patients (five female, seven male) with acute renal failure undergoing CVVH using a 0.7 m(2) polysulphone high-flux membrane were investigated. All patients received ceftazidime 2 g i.v. q8h. Peak ceftazidime concentrations were 58.2 +/- 11.6 mg/L, with trough concentrations 14.0 +/- 3.2 mg/L at the arterial port. The elimination half-life, haemofiltration clearance, volume of distribution and total removal were 4.3 +/- 0.6 h, 32.1 +/- 7.9 mL/min, 36.4 +/- 6.4 L and 74.5 +/- 6.5%, respectively. Based on these pharmacokinetic parameters and that maximal killing is at 4 x MIC we recommend at least ceftazidime 2 g i.v. q8h.
Traunmüller
Friederike
F
Department of Internal Medicine I, Division of Infectious Diseases, University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
Schenk
Peter
P
Mittermeyer
Christoph
C
Thalhammer-Scherrer
Renate
R
Ratheiser
Klaus
K
Thalhammer
Florian
F
D058186:Acute Kidney Injury / Q000097:blood / Q000188:drug therapy / Q000378:metabolism; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D002442:Ceftazidime / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics*; D002511:Cephalosporins / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics*; D016638:Critical Illness / Q000628:therapy*; D004334:Drug Administration Schedule; D005260:Female; D006440:Hemofiltration / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008657:Metabolic Clearance Rate / Q000502:physiology; D008875:Middle Aged; D011446:Prospective Studies
D002511:Cephalosporins; D002442:Ceftazidime