Pharmacokinetics and elimination efficiency of linezolid during dialysis.
Linezolid (LZD) is an option for treating infections caused by multi-resistant Gram-positive bacteria. The protein-binding rate of LZD markedly influences its elimination by dialysis, with limited data suggesting that LZD is cleared by intermittent hemodialysis. Here, we investigated the protein-binding rate and elimination efficiency of LZD in a sepsis patient receiving dialysis. The oral administration of LZD at 600 mg/day resulted in protein-binding and free rates of the drug of 20.4% and 79.6%, respectively, 24 h after administration. By comparing the LZD concentration before and after dialysis, the elimination efficiency of free LZD as a result of dialysis was found to be 40.6%. Our sepsis patient showed higher plasma concentrations of LZD at trough after hemodialysis than the reported concentrations in normal renal function patients. However, it is not clear from our present findings if a relationship exists between myelosuppression and plasma LZD concentration.
Department of Pharmacy, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan. hiraki@kumamoto2.hosp.go.jp
Yoichi
Y
Hiraki
Yasuhiro
Y
Tsuji
Nobuhiro
N
Misumi
Mikako
M
Hiraike
Kana
K
Matsumoto
Kunihiko
K
Morita
Hidetoshi
H
Kamimura
Yoshiharu
Y
Karube
D000081:Acetamides / Q000097:blood / Q000493:pharmacokinetics*; D000368:Aged; D000671:Amputation, Surgical / Q000009:adverse effects; D000890:Anti-Infective Agents / Q000097:blood / Q000493:pharmacokinetics*; D016470:Bacteremia / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D000069349:Linezolid; D055624:Methicillin-Resistant Staphylococcus aureus; D023303:Oxazolidinones / Q000097:blood / Q000493:pharmacokinetics*; D006435:Renal Dialysis; D013203:Staphylococcal Infections / Q000188:drug therapy*; D013530:Surgical Wound Infection / Q000150:complications / Q000188:drug therapy / Q000382:microbiology
D000081:Acetamides; D000890:Anti-Infective Agents; D023303:Oxazolidinones; D000069349:Linezolid