title: Gentamicin pharmacokinetics during continuous venovenous hemofiltration in critically ill septic patients.
abstract: OBJECTIVE
  Current dosing recommendations for administration of gentamicin to septic patients with acute kidney injury (AKI) on continuous venovenous hemofiltration (CVVH) at a filtration rate of 45 ml/kg/h are missing.
  
  
  OBJECTIVE
  To describe gentamicin pharmacokinetics and to find an optimal dosing regimen in patients on CVVH.
  
  
  METHODS
  Seven adult patients were included. Patients received loading dose of 240 mg followed by application of maintenance dose every 24 hours. Maintenance dose was adjusted according to gentamicin C(max)/MIC ratio and drug levels simulation using a pharmacokinetic programme.
  
  
  RESULTS
  Median total clearance (0.59-0.79 ml/min/kg) was similar to patients with normal renal function; median volume of distribution was higher than observed in non-septic patients (about 0.5 l/kg versus 0.25 l/kg). Patients with diuresis required an increase of gentamicin dose to reach C(max)/MIC ratio.
  
  
  CONCLUSIONS
  Septic patients with AKI on CVVH (45 ml/kg/h) require a loading dose of 240 mg, followed by therapeutic drug monitoring to optimize maintenance dose.
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, University of Ostrava and University Hospital Ostrava, Czech Republic. jankaduricova82@gmail.com
authors.forename: Nadezda
authors.initials: N
authors.lastname: Petejova
authors.forename: Jana
authors.initials: J
authors.lastname: Zahalkova
authors.forename: Jana
authors.initials: J
authors.lastname: Duricova
authors.forename: Ivana
authors.initials: I
authors.lastname: Kacirova
authors.forename: Hana
authors.initials: H
authors.lastname: Brozmanova
authors.forename: Karel
authors.initials: K
authors.lastname: Urbanek
authors.forename: Milan
authors.initials: M
authors.lastname: Grundmann
authors.forename: Arnost
authors.initials: A
authors.lastname: Martinek
mesh_terms: D058186:Acute Kidney Injury / Q000188:drug therapy* / Q000209:etiology; D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics*; D016638:Critical Illness / Q000628:therapy*; D016903:Drug Monitoring; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics*; D006440:Hemofiltration; D006801:Humans; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D018805:Sepsis / Q000150:complications* / Q000188:drug therapy; D014018:Tissue Distribution
chemical_list: D000890:Anti-Infective Agents; D005839:Gentamicins