title: Removal of doripenem during hemodialysis and the optimum dosing regimen for patients undergoing hemodialysis.
abstract: The removal of doripenem by hemodialysis was studied in six hemodialysis patients. Following an intravenous drip infusion of 0.5 g of doripenem, plasma concentrations of the drug were measured. The decrease in drug concentrations in plasma was observed during various periods of non-hemodialysis, and hemodialysis accelerated the elimination of doripenem. For example, the calculated mean half-life during hemodialysis was significantly shorter than that during non-hemodialysis periods (P = 0.002). The calculated pharmacokinetic parameters indicated that the mean rate of decrease in plasma concentration due to hemodialysis alone was 56.12 ± 8.11%. Upon obtaining these results and several pharmacokinetic parameters, we attempted to optimize the dosing regimen of doripenem for hemodialysis patients. We recommend the use of 0.25 g of doripenem once a day in patients infected with viable bacteria, and in patients who are infected with Pseudomonas aeruginosa, 0.5 g twice a day on the first day of administration, followed by 0.5 g once a day.
authors.affiliation: Division of Clinical Pharmacology, Faculty of Pharmaceutical Sciences, Kumamoto University, Oe-honmachi Dialysis Center, Kumamoto University Hospital, Honjo, Japan. hirata@kumamoto-u.ac.jp
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Tanoue
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nishi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kadowaki
authors.forename: Sumio
authors.initials: S
authors.lastname: Hirata
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000493:pharmacokinetics*; D015780:Carbapenems / Q000008:administration & dosage / Q000493:pharmacokinetics*; D000077726:Doripenem; D004305:Dose-Response Relationship, Drug; D005260:Female; D006207:Half-Life; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D006435:Renal Dialysis / Q000379:methods*
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D000077726:Doripenem