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Crrt, meropenem

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https://www.readbyqxmd.com/read/27851486/1851-continuous-infusion-of-meropenem-in-a-patient-on-ecmo-and-crrt
#1
Yasir Alqaqaa, Robert Witcher, Michelle Ramirez, Jason Fisher, Laura Malaga-Dieguez, Arun Chopra
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/26997934/pharmacokinetics-of-continuous-infusion-meropenem-with-concurrent-extracorporeal-life-support-and-continuous-renal-replacement-therapy-a-case-report
#2
Jeffrey J Cies, Wayne S Moore, Susan B Conley, Mindy J Dickerman, Christine Small, Dominick Carella, Paul Shea, Jason Parker, Arun Chopra
Pharmacokinetic parameters can be significantly altered for both extracorporeal life support (ECLS) and continuous renal replacement therapy (CRRT). This case report describes the pharmacokinetics of continuous-infusion meropenem in a patient on ECLS with concurrent CRRT. A 2.8-kg, 10-day-old, full-term neonate born via spontaneous vaginal delivery presented with hypothermia, lethargy, and a ~500-g weight loss from birth. She progressed to respiratory failure on hospital day 2 (HD 2) and developed sepsis, disseminated intravascular coagulation, and liver failure as a result of disseminated adenoviral infection...
January 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/26349527/can-we-use-an-ex-vivo-continuous-hemofiltration-model-to-describe-the-adsorption-and-elimination-of-meropenem-and-piperacillin
#3
Janattul-Ain Jamal, Andrew A Udy, Steven C Wallis, Dwarakanathan Ranganathan, Brett C McWhinney, Jacobus P J Ungerer, Jeffrey Lipman, Jason A Roberts
OBJECTIVES: To determine the adsorption and elimination characteristics of meropenem and piperacillin during simulated continuous renal replacement therapy (CRRT), and to compare the observed data from this ex vivo study with previous data from clinical studies. METHOD: This was an experimental study utilizing a modified CRRT circuit and polysulfone membrane (1.2 m2), circulated with a blood-crystalloid mixture. Adsorption onto the CRRT circuit was tested over a 4-h period, and clearance was assessed separately using variable continuous hemofiltration settings...
August 2015: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/26222329/pharmacokinetics-of-meropenem-in-children-receiving-continuous-renal-replacement-therapy-validation-of-clinical-trial-simulations
#4
Edward J Nehus, Tomoyuki Mizuno, Shareen Cox, Stuart L Goldstein, Alexander A Vinks
Meropenem is frequently prescribed in critically ill children receiving continuous renal replacement therapy (CRRT). We previously used clinical trial simulations to evaluate dosing regimens of meropenem in this population and reported that a dose of 20 mg/kg every 12 hours optimizes target attainment. Meropenem pharmacokinetics were investigated in this prospective, open-label study to validate our previous in silico predictions. Seven patients received meropenem (13.8-22 mg/kg) administered intravenously every 12 hours as part of standard care...
March 2016: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/26124172/meropenem-population-pharmacokinetics-in-critically-ill-patients-with-septic-shock-and-continuous-renal-replacement-therapy-influence-of-residual-diuresis-on-dose-requirements
#5
Marta Ulldemolins, Dolors Soy, Mireia Llaurado-Serra, Sergi Vaquer, Pedro Castro, Alejandro H Rodríguez, Caridad Pontes, Gonzalo Calvo, Antoni Torres, Ignacio Martín-Loeches
Meropenem dosing in critically ill patients with septic shock and continuous renal replacement therapy (CRRT) is complex, with the recommended maintenance doses being 500 mg to 1,000 mg every 8 h (q8h) to every 12 h. This multicenter study aimed to describe the pharmacokinetics (PKs) of meropenem in this population to identify the sources of PK variability and to evaluate different dosing regimens to develop recommendations based on clinical parameters. Thirty patients with septic shock and CRRT receiving meropenem were enrolled (153 plasma samples were tested)...
September 2015: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/25881576/a-multicenter-study-on-the-effect-of-continuous-hemodiafiltration-intensity-on-antibiotic-pharmacokinetics
#6
RANDOMIZED CONTROLLED TRIAL
Darren M Roberts, Xin Liu, Jason A Roberts, Priya Nair, Louise Cole, Michael S Roberts, Jeffrey Lipman, Rinaldo Bellomo
INTRODUCTION: Continuous renal replacement therapy (CRRT) may alter antibiotic pharmacokinetics and increase the risk of incorrect dosing. In a nested cohort within a large randomized controlled trial, we assessed the effect of higher (40 mL/kg per hour) and lower (25 mL/kg per hour) intensity CRRT on antibiotic pharmacokinetics. METHODS: We collected serial blood samples to measure ciprofloxacin, meropenem, piperacillin-tazobactam, and vancomycin levels. We calculated extracorporeal clearance (CL), systemic CL, and volume of distribution (Vd) by non-linear mixed-effects modelling...
2015: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/25777909/a-multicenter-study-on-the-effect-of-continuous-hemodiafiltration-intensity-on-antibiotic-pharmacokinetics
#7
Darren M Roberts, Xin Liu, Jason A Roberts, Priya Nair, Louise Cole, Michael S Roberts, Jeffrey Lipman, Rinaldo Bellomo
INTRODUCTION: Continuous renal replacement therapy (CRRT) may alter antibiotic pharmacokinetics and increase the risk of incorrect dosing. In a nested cohort within a large randomized controlled trial, we assessed the effect of higher (40 mL/kg/hour) and lower (25 mL/kg/hour) intensity CRRT on antibiotic pharmacokinetics. METHODS: We collected serial blood samples to measure ciprofloxacin, meropenem, piperacillin-tazobactam and vancomycin levels. We calculated extracorporeal clearance (CL), systemic CL and volume of distribution (Vd) by nonlinear mixed effects modelling...
December 2015: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/25042938/beta-lactam-dosing-in-critically-ill-patients-with-septic-shock-and-continuous-renal-replacement-therapy
#8
REVIEW
Marta Ulldemolins, Sergi Vaquer, Mireia Llauradó-Serra, Caridad Pontes, Gonzalo Calvo, Dolors Soy, Ignacio Martín-Loeches
Although early and appropriate antibiotic therapy remains the most important intervention for successful treatment of septic shock, data guiding optimization of beta-lactam prescription in critically ill patients prescribed with continuous renal replacement therapy (CRRT) are still limited. Being small hydrophilic molecules, beta-lactams are likely to be cleared by CRRT to a significant extent. As a result, additional variability may be introduced to the per se variable antibiotic concentrations in critically ill patients...
2014: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/25042683/meropenem-in-children-receiving-continuous-renal-replacement-therapy-clinical-trial-simulations-using-realistic-covariates
#9
Edward J Nehus, Samer Mouksassi, Alexander A Vinks, Stuart Goldstein
Meropenem is frequently prescribed in children receiving continuous renal replacement therapy (CRRT). Fluid overload is often present in critically ill children and affects drug disposition. The purpose of this study was to develop a pharmacokinetic model to (1) evaluate target attainment of meropenem dosing regimens against P. aeruginosa in children receiving CRRT and (2) estimate the effect of fluid overload on target attainment. Clinical trial simulations were employed to evaluate target attainment of meropenem in various age groups and degrees of fluid overload in children receiving CRRT...
December 2014: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/24886826/%C3%AE-lactam-antibiotic-concentrations-during-continuous-renal-replacement-therapy
#10
Marjorie Beumier, Giuseppe Stefano Casu, Maya Hites, Lucie Seyler, Frederic Cotton, Jean-Louis Vincent, Frédérique Jacobs, Fabio Silvio Taccone
INTRODUCTION: The use of standard doses of β-lactam antibiotics during continuous renal replacement therapy (CRRT) may result in inadequate serum concentrations. The aim of this study was to evaluate the adequacy of unadjusted drug regimens (i.e., similar to those used in patients with normal renal function) in patients treated with CRRT and the influence of CRRT intensity on drug clearance. METHODS: We reviewed data from 50 consecutive adult patients admitted to our Department of Intensive Care in whom routine therapeutic drug monitoring (TDM) of broad-spectrum β-lactam antibiotics (ceftazidime or cefepime, CEF; piperacillin/tazobactam; TZP; meropenem, MEM) was performed using unadjusted β-lactam antibiotics regimens (CEF = 2 g q8h; TZP = 4 g q6h; MEM = 1 g q8h)...
May 22, 2014: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/21649882/recommended-%C3%AE-lactam-regimens-are-inadequate-in-septic-patients-treated-with-continuous-renal-replacement-therapy
#11
Lucie Seyler, Frédéric Cotton, Fabio Silvio Taccone, Daniel De Backer, Pascale Macours, Jean-Louis Vincent, Frédérique Jacobs
INTRODUCTION: Sepsis is responsible for important alterations in the pharmacokinetics of antibiotics. Continuous renal replacement therapy (CRRT), which is commonly used in septic patients, may further contribute to pharmacokinetic changes. Current recommendations for antibiotic doses during CRRT combine data obtained from heterogeneous patient populations in which different CRRT devices and techniques have been used. We studied whether these recommendations met optimal pharmacokinetic criteria for broad-spectrum antibiotic levels in septic shock patients undergoing CRRT...
2011: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/18307371/population-pharmacokinetics-of-meropenem-in-critically-ill-patients-undergoing-continuous-renal-replacement-therapy
#12
Arantxazu Isla, Alicia Rodríguez-Gascón, Iñaki F Trocóniz, Lorea Bueno, María Angeles Solinís, Javier Maynar, José Angel Sánchez-Izquierdo, José Luis Pedraz
BACKGROUND AND OBJECTIVE: Meropenem is a carbapenem antibacterial frequently prescribed for the treatment of severe infections in critically ill patients, including those receiving continuous renal replacement therapy (CRRT). The objective of this study was to develop a population pharmacokinetic model of meropenem in critically ill patients undergoing CRRT. PATIENTS AND METHODS: A prospective, open-label study was conducted in 20 patients undergoing CRRT. Blood and dialysate-ultrafiltrate samples were obtained after administration of 500 mg, 1000 mg or 2000 mg of meropenem every 6 or 8 hours by intravenous infusion...
2008: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/18297267/pharmacokinetics-of-meropenem-during-intermittent-and-continuous-intravenous-application-in-patients-treated-by-continuous-renal-replacement-therapy
#13
RANDOMIZED CONTROLLED TRIAL
Julia Langgartner, Antje Vasold, Thomas Glück, Michel Reng, Frieder Kees
OBJECTIVE: The clinical effect of beta-lactam antibiotics depends on the time of drug concentration above the minimal inhibitory concentration (MIC) for a susceptible bacterium. Continuous infusion (CI) of beta-lactams such as meropenem may therefore be a more rational approach than intermittent bolus injections (IB). The aim of this study was to test whether CI of meropenem achieves effective drug concentrations comparable to IB in patients treated by continuous renal replacement therapy (CRRT)...
June 2008: Intensive Care Medicine
https://www.readbyqxmd.com/read/16163635/antibiotic-dosing-in-critically-ill-adult-patients-receiving-continuous-renal-replacement-therapy
#14
REVIEW
Robin L Trotman, John C Williamson, D Matthew Shoemaker, William L Salzer
Continuous renal replacement therapy (CRRT) is now commonly used as a means of support for critically ill patients with renal failure. No recent comprehensive guidelines exist that provide antibiotic dosing recommendations for adult patients receiving CRRT. Doses used in intermittent hemodialysis cannot be directly applied to these patients, and antibiotic pharmacokinetics are different than those in patients with normal renal function. We reviewed the literature for studies involving the following antibiotics frequently used to treat critically ill adult patients receiving CRRT: vancomycin, linezolid, daptomycin, meropenem, imipenem-cilastatin, nafcillin, ampicillin-sulbactam, piperacillin-tazobactam, ticarcillin-clavulanic acid, cefazolin, cefotaxime, ceftriaxone, ceftazidime, cefepime, aztreonam, ciprofloxacin, levofloxacin, moxifloxacin, clindamycin, colistin, amikacin, gentamicin, tobramycin, fluconazole, itraconazole, voriconazole, amphotericin B (deoxycholate and lipid formulations), and acyclovir...
October 15, 2005: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/11069213/pharmacokinetics-of-meropenem-in-patients-with-renal-failure-and-patients-receiving-renal-replacement-therapy
#15
REVIEW
F Thalhammer, W H Hörl
Meropenem is a well established carbapenem antibacterial with a wide spectrum of activity against Gram-positive and Gram-negative bacteria, including beta-lactamase producers and Pseudomonas aeruginosa. Because of its clinical and bacteriological efficacy, meropenem is an important antimicrobial drug in the treatment of serious infections in adults and in children. Meropenem is predominately excreted unchanged in the urine, and thus dosage adjustments are necessary in patients with renal insufficiency and those undergoing intermittent haemodialysis (IHD) or various forms of continuous renal replacement therapy (CRRT), such as continuous venovenous haemodialysis, continuous venovenous haemodiafiltration (CVVHDF), continuous venovenous haemofiltration (CVVHF) or continuous ambulatory peritoneal dialysis (CAPD)...
October 2000: Clinical Pharmacokinetics
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