title: Pharmacokinetics of teicoplanin during continuous hemofiltration with a new and a 24-h used highly permeable membrane: rationale for therapeutic drug monitoring-guided dosage.
abstract: OBJECTIVE
  Continuous venovenous hemofiltration (CVVH) is widely used in the management of critically ill patients, but only few administration guidelines for antimicrobial drugs are available. It is unclear whether the use of a filter for more than 24 hours might lead to less efficient extraction. This study describes the pharmacokinetics of teicoplanin during CVVH using a highly permeable membrane.
  
  
  METHODS
  Pharmacokinetics of teicoplanin during continuous hemofiltration with a new (group 1) and a 24-h used (group 2), highly permeable polyamide membrane were assessed in 3 patients.
  
  
  RESULTS
  The teicoplanin serum concentrations (44.0 +/- 18.5 mg/l vs 109.5 +/- 34.5 mg/l) and half-life of teicoplanin (4.6 +/- 1.1 h vs 5.2 +/- 0.7 h) differed significantly between the 2 groups indicating a smaller elimination of the drug on the second day. Substantial binding of teicoplanin to filter membranes could explain this observation.
  
  
  CONCLUSIONS
  The results suggest that daily adjustment of the dosage is necessary to achieve sufficient teicoplanin concentrations and a fixed dosage recommendation is not suitable for this drug.
authors.affiliation: Department of Internal Medicine I, Division of Infectious Diseases, University of Vienna, Austria.
authors.forename: B
authors.initials: B
authors.lastname: Meyer
authors.forename: F
authors.initials: F
authors.lastname: Traunmüller
authors.forename: A
authors.initials: A
authors.lastname: Hamwi
authors.forename: U M
authors.initials: UM
authors.lastname: Hollenstein
authors.forename: G J
authors.initials: GJ
authors.lastname: Locker
authors.forename: W R
authors.initials: WR
authors.lastname: Sperr
authors.forename: T
authors.initials: T
authors.lastname: Staudinger
authors.forename: R
authors.initials: R
authors.lastname: Thalhammer-Scherrer
authors.forename: H
authors.initials: H
authors.lastname: Burgmann
authors.forename: F
authors.initials: F
authors.lastname: Thalhammer
mesh_terms: D000900:Anti-Bacterial Agents / Q000097:blood / Q000493:pharmacokinetics*; D019540:Area Under Curve; D006207:Half-Life; D006440:Hemofiltration / Q000379:methods; D006801:Humans; D008567:Membranes, Artificial; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D017334:Teicoplanin / Q000097:blood / Q000493:pharmacokinetics*
chemical_list: D000900:Anti-Bacterial Agents; D008567:Membranes, Artificial; D017334:Teicoplanin