title: Pharmacokinetic analysis of antibiotic adsorption (vancomycin and teicoplanin) by the Lixelle extracorporeal unit.
abstract: OBJECTIVE
  The pharmacokinetic properties of vancomycin (VAN) and teicoplanin (TEC) may be affected by adsorption during hemofiltration as well as hemoperfusion therapies. The aim of this in vitro study was to investigate VAN and TEC removal adsorption kinetics with mass balance analysis by direct hemoperfusion (DHP) with the Lixelle S-35 cartridge (Lixelle, Kaneka Corporation, Tokyo).
  
  
  METHODS
  Mock DHP was performed for 120 min using VAN and TEC solutions (46.08 ± 0.81 and 74.79 ± 1.24 mg/l per N = 6). Clinical plasma antibiotic concentrations were circulated in a closed circuit simulating DHP using an adsorption column (Lixelle S-35) at flow rate of 250 ml/min. Samples were collected at 10, 60, and 120 min through both arterial and venous ports; drug levels were measured with particle enhanced turbidimetric inhibition immunoassay and fluorescence polarization immunoassay. All tests were performed in triplicate.
  
  
  RESULTS
  Results subsequent to DHP at the primary assessment interval for VAN mass was 49.06 ± 1.47 mg, indicating a significant reduction of the starting mass (94.74 ± 1.63 mg). The observed reduction of TEC levels greatly exceeded that of VAN at the first interval (10 min). At 120 min of DHP, the estimated mass adsorption of VAN was 45.68 ± 2.26 mg, while the mesured total TEC mass adsorbed was 126.86 ± 0.91 mg.
  
  
  CONCLUSIONS
  A VAN adsorption plateau indicating the VAN loading dose may be required in patients receiving DHP with the Lixelle S-35. The total TEC mass was adsorbed subsequent to 60 min of circulation, so the loading dose should be closely considered. In addition, the Lixelle S-35 may represent an option as a rescue therapy in accidental overdose of TEC.
authors: 4 Department of Molecular Medicine, University of Padua, Padua - Italy.
authors: Marco
authors: M
authors: Sartori
authors: Sonya
authors: S
authors: Day
authors: Silvia
authors: S
authors: De Rosa
authors: Maria G
authors: MG
authors: Ricatti
authors: Federico
authors: F
authors: Nalesso
authors: Mirella
authors: M
authors: Zancato
authors: Claudio
authors: C
authors: Ronco
mesh_terms: D000327:Adsorption / Q000187:drug effects / Q000502:physiology; D004305:Dose-Response Relationship, Drug; D006440:Hemofiltration / Q000295:instrumentation*; D006464:Hemoperfusion / Q000295:instrumentation*; D006801:Humans; D066298:In Vitro Techniques; D006435:Renal Dialysis / Q000379:methods; D012680:Sensitivity and Specificity; D017334:Teicoplanin / Q000493:pharmacokinetics* / Q000494:pharmacology; D014640:Vancomycin / Q000493:pharmacokinetics* / Q000494:pharmacology
chemical_list: D017334:Teicoplanin; D014640:Vancomycin