Risk of underdosing of ampicillin/sulbactam in patients with acute kidney injury undergoing extended daily dialysis--a single case.
The fixed antibacterial combination of ampicillin and sulbactam is frequently used for various infections. The normal kidneys eliminate approximately 60% of ampicillin (371.39 Da) and sulbactam (255.22 Da). Concomitant with the decline in renal function, the terminal elimination half-life increases from 1 up to 24 h in patients with ESRD. Patients on three times weekly low flux haemodialysis exhibit a half-life of 2.3 h on and 17.4 h off dialysis. In contrast, in the present observation the elimination half-life in a single patient with acute kidney injury undergoing extended daily dialysis (EDD) with a polysulphone membrane was 1.5 h, indicating that the current dosing regimen for haemodialysis outpatients (ampicillin/sulbactam 2.0/1.0 g/day) would result in a significant underdosing for patients undergoing EDD.
Kielstein
Jan T
JT
Division of Nephrology and Hypertension, Department of Internal Medicine, Medical School Hannover, Hannover, Germany. Kielstein@yahoo.com
Lorenzen
Johan
J
Kaever
Volkhard
V
Burhenne
Heike
H
Broll
Michael
M
Hafer
Carsten
C
Burkhardt
Olaf
O
D058186:Acute Kidney Injury / Q000628:therapy*; D000368:Aged; D000667:Ampicillin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D013293:Enterococcus faecalis; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D006435:Renal Dialysis; D012307:Risk Factors; D013407:Sulbactam / Q000008:administration & dosage; D014552:Urinary Tract Infections / Q000188:drug therapy*
D000900:Anti-Bacterial Agents; C035444:sultamicillin; D000667:Ampicillin; D013407:Sulbactam