Teicoplanin pharmacokinetics in critically ill patients on continuous veno-venous hemofiltration.
Pharmacokinetics of teicoplanin (TP) was assessed in critically ill patients on continuous veno-venous hemofiltration (CVVH), in eleven patients, after the first dose and in another four after repeated administration. The TP peak concentration amounted to 55.44 +/- 15.90 microg/ml and 81.28 +/- 28.55 microg/ml (mean +/- SD), the trough concentration 6.4 +/- 1.7 microg/ml and 21.3 +/- 5.0 microg/ml, the half-life 15.7 +/- 5.7 and 35.1 +/- 12.3 h, the apparent volume of distribution 0.84 +/- 0.22 and 0.48 +/- 0.09 l/kg and the TP clearance 39 +/- 12 and 11 +/- 4 ml/h/kg after the first dose and after repeated administration, respectively. The mean sieving coefficient of TP was 0.15. After a 1,200 mg loading dose, daily maintenance doses of 600 - 1,800 mg were required for achieving trough levels of 15 - 25 microg/ml. Therapeutic drug monitoring is indispensable during CVVH because of a considerable variability of TP pharmacokinetics.
Bellmann
R
R
Clinical Pharmacokinetics Unit, Laboratory of Inflammation Research, Department of Internal Medicine I, Innsbruck Medical University, Innsbruck, Austria. romuald.bellmann@i-med.ac.at
Falkensammer
G
G
Seger
C
C
Weiler
S
S
Kountchev
J
J
Joannidis
M
M
D058186:Acute Kidney Injury / Q000378:metabolism; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics*; D019540:Area Under Curve; D016638:Critical Illness; D005260:Female; D006207:Half-Life; D006440:Hemofiltration; D006801:Humans; D008297:Male; D008875:Middle Aged; D017334:Teicoplanin / Q000493:pharmacokinetics*; D055815:Young Adult
D000900:Anti-Bacterial Agents; D017334:Teicoplanin