Pharmacokinetics of meropenem in critically ill patients receiving continuous venovenous haemofiltration: A randomized controlled trial of continuous infusion versus intermittent bolus administration

The objective of this study was to describe the pharmacokinetics of meropenem, administered by continuous infusion (CI) or intermittent bolus (IB), in critically ill patients receiving continuous venovenous haemofiltration (CVVH) and to evaluate the frequency of pharmacokinetic/pharmacodynamic targ...

Full description

Saved in:
Bibliographic Details
Main Authors: Jamal, Janattul-Ain, Mat Nor, Mohd Basri, Mohamad Nor, Fariz Safhan, Udy, Andrew A, Wallis, Steven C, Lipman, Jeffrey, Roberts, Jason A.
Format: Article
Language:English
Published: Elsevier 2015
Subjects:
Online Access:http://irep.iium.edu.my/40454/1/pharmacokinetics_of_meropenem_IJAA.pdf
http://irep.iium.edu.my/40454/
http://www.journals.elsevier.com/international-journal-of-antimicrobial-agents
http://dx.doi.org/10.1016/j.ijantimicag.2014.09.009
Tags: Add Tag
No Tags, Be the first to tag this record!
Institution: Universiti Islam Antarabangsa Malaysia
Language: English
id my.iium.irep.40454
record_format dspace
spelling my.iium.irep.404542017-04-06T08:15:10Z http://irep.iium.edu.my/40454/ Pharmacokinetics of meropenem in critically ill patients receiving continuous venovenous haemofiltration: A randomized controlled trial of continuous infusion versus intermittent bolus administration Jamal, Janattul-Ain Mat Nor, Mohd Basri Mohamad Nor, Fariz Safhan Udy, Andrew A Wallis, Steven C Lipman, Jeffrey Roberts, Jason A. RM Therapeutics. Pharmacology The objective of this study was to describe the pharmacokinetics of meropenem, administered by continuous infusion (CI) or intermittent bolus (IB), in critically ill patients receiving continuous venovenous haemofiltration (CVVH) and to evaluate the frequency of pharmacokinetic/pharmacodynamic target attainment with each dosing strategy. This was a prospective, randomised controlled trial in critically ill patients receiving CVVH and administered meropenem by CI or IB. Serial meropenem concentrations in plasma and ultrafiltrate were measured after administration of a standard total daily dose (4 g/day on Day 1, followed by 3 g/day thereafter) on two occasions during antibiotic therapy. Meropenem pharmacokinetic parameters were calculated using a non-compartmental approach. Sixteen critically ill patients receiving CVVH concurrently treated with meropenem were randomised to CI (n=8) orIB dosing (n= 8). IB administration resulted in higher maximum concentrations (Cmax) [64.7 (58.9–80.3)and 64.8 (48.5–81.8) mg/L, respectively] on both sampling occasions compared with CI (P< 0.01 and P= 0.04, respectively). CI resulted in a higher meropenem steady-state concentration (Css) on occasion 1 [26.0 (24.5–41.6) mg/L] compared with the minimum concentration (Cmin) observed for IB patients [17.0(15.7–19.8) mg/L;P< 0.01]. CVVH contributed to ca. 50% of meropenem total clearance in these patients. The administered meropenem doses resulted in plasma drug concentrations that were >4×the targeted susceptibility breakpoint (2 mg/L) for 100% of the dosing interval, for both groups, on both occasions. CI could be an alternative to IB for meropenem administration in critically ill patients receiving CVVH. Elsevier 2015-01-01 Article REM application/pdf en http://irep.iium.edu.my/40454/1/pharmacokinetics_of_meropenem_IJAA.pdf Jamal, Janattul-Ain and Mat Nor, Mohd Basri and Mohamad Nor, Fariz Safhan and Udy, Andrew A and Wallis, Steven C and Lipman, Jeffrey and Roberts, Jason A. (2015) Pharmacokinetics of meropenem in critically ill patients receiving continuous venovenous haemofiltration: A randomized controlled trial of continuous infusion versus intermittent bolus administration. International Journal of Antimicrobial Agents , 45 (1). pp. 41-45. ISSN 0924-8579 http://www.journals.elsevier.com/international-journal-of-antimicrobial-agents http://dx.doi.org/10.1016/j.ijantimicag.2014.09.009
institution Universiti Islam Antarabangsa Malaysia
building IIUM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider International Islamic University Malaysia
content_source IIUM Repository (IREP)
url_provider http://irep.iium.edu.my/
language English
topic RM Therapeutics. Pharmacology
spellingShingle RM Therapeutics. Pharmacology
Jamal, Janattul-Ain
Mat Nor, Mohd Basri
Mohamad Nor, Fariz Safhan
Udy, Andrew A
Wallis, Steven C
Lipman, Jeffrey
Roberts, Jason A.
Pharmacokinetics of meropenem in critically ill patients receiving continuous venovenous haemofiltration: A randomized controlled trial of continuous infusion versus intermittent bolus administration
description The objective of this study was to describe the pharmacokinetics of meropenem, administered by continuous infusion (CI) or intermittent bolus (IB), in critically ill patients receiving continuous venovenous haemofiltration (CVVH) and to evaluate the frequency of pharmacokinetic/pharmacodynamic target attainment with each dosing strategy. This was a prospective, randomised controlled trial in critically ill patients receiving CVVH and administered meropenem by CI or IB. Serial meropenem concentrations in plasma and ultrafiltrate were measured after administration of a standard total daily dose (4 g/day on Day 1, followed by 3 g/day thereafter) on two occasions during antibiotic therapy. Meropenem pharmacokinetic parameters were calculated using a non-compartmental approach. Sixteen critically ill patients receiving CVVH concurrently treated with meropenem were randomised to CI (n=8) orIB dosing (n= 8). IB administration resulted in higher maximum concentrations (Cmax) [64.7 (58.9–80.3)and 64.8 (48.5–81.8) mg/L, respectively] on both sampling occasions compared with CI (P< 0.01 and P= 0.04, respectively). CI resulted in a higher meropenem steady-state concentration (Css) on occasion 1 [26.0 (24.5–41.6) mg/L] compared with the minimum concentration (Cmin) observed for IB patients [17.0(15.7–19.8) mg/L;P< 0.01]. CVVH contributed to ca. 50% of meropenem total clearance in these patients. The administered meropenem doses resulted in plasma drug concentrations that were >4×the targeted susceptibility breakpoint (2 mg/L) for 100% of the dosing interval, for both groups, on both occasions. CI could be an alternative to IB for meropenem administration in critically ill patients receiving CVVH.
format Article
author Jamal, Janattul-Ain
Mat Nor, Mohd Basri
Mohamad Nor, Fariz Safhan
Udy, Andrew A
Wallis, Steven C
Lipman, Jeffrey
Roberts, Jason A.
author_facet Jamal, Janattul-Ain
Mat Nor, Mohd Basri
Mohamad Nor, Fariz Safhan
Udy, Andrew A
Wallis, Steven C
Lipman, Jeffrey
Roberts, Jason A.
author_sort Jamal, Janattul-Ain
title Pharmacokinetics of meropenem in critically ill patients receiving continuous venovenous haemofiltration: A randomized controlled trial of continuous infusion versus intermittent bolus administration
title_short Pharmacokinetics of meropenem in critically ill patients receiving continuous venovenous haemofiltration: A randomized controlled trial of continuous infusion versus intermittent bolus administration
title_full Pharmacokinetics of meropenem in critically ill patients receiving continuous venovenous haemofiltration: A randomized controlled trial of continuous infusion versus intermittent bolus administration
title_fullStr Pharmacokinetics of meropenem in critically ill patients receiving continuous venovenous haemofiltration: A randomized controlled trial of continuous infusion versus intermittent bolus administration
title_full_unstemmed Pharmacokinetics of meropenem in critically ill patients receiving continuous venovenous haemofiltration: A randomized controlled trial of continuous infusion versus intermittent bolus administration
title_sort pharmacokinetics of meropenem in critically ill patients receiving continuous venovenous haemofiltration: a randomized controlled trial of continuous infusion versus intermittent bolus administration
publisher Elsevier
publishDate 2015
url http://irep.iium.edu.my/40454/1/pharmacokinetics_of_meropenem_IJAA.pdf
http://irep.iium.edu.my/40454/
http://www.journals.elsevier.com/international-journal-of-antimicrobial-agents
http://dx.doi.org/10.1016/j.ijantimicag.2014.09.009
_version_ 1643611830452486144