Pharmacokinetics of ceftriaxone in patients undergoing continuous renal replacement therapy
-
Koji Goto
,
Norihisa Yasuda
Abstract
Background:
The duration of time for which the serum levels exceed the minimum inhibitory concentration (MIC) is an important pharmacokinetics (PK)/pharmacodynamics (PD) parameter correlating with efficacy for the antibiotic, ceftriaxone (CTRX). However, no reports exist regarding the PK or PD in patients undergoing continuous renal replacement therapy (CRRT). The purpose of this study was to examine the PK and safety of CTRX in patients undergoing CRRT in order to establish safer and more effective regimens.
Methods:
CTRX (1 g once a day) was intravenously administered four or more times to nine patients undergoing CRRT. Blood was collected after administration to measure CTRX concentrations in serum and the filtration fraction of CRRT by high-performance liquid chromatography. In addition to calculating PK parameters from serum CTRX, we (a) estimated by simulation CTRX concentrations when the dose interval was extended to once every 2 or 3 days, (b) calculated CTRX clearance via CRRT from CTRX concentrations in the filtration fraction, and (c) assessed the safety of CTRX use.
Results:
Total body clearance and the half-life of CTRX were 7.46 mL/min (mean) and 26.5 h, respectively, in patients undergoing CRRT. CTRX was found in the filtration fraction, and the estimated clearance by CRRT was about 70% of total body clearance. Simulations revealed that even when the dose interval is increased to 2 or 3 days, CTRX would retain its efficacy.
Conclusions:
Our findings suggest that, depending on the condition of patients undergoing CRRT, CTRX could be used safely against pathogens with a CTRX MIC ≤2 µg/mL, even when extending the dose interval.
Acknowledgments
We would like to thank all staff and patients who were willing to participate in this study. This study was supported by the Intensive Care Unit, Oita University Hospital. We are grateful to the ICU staff for their understanding and cooperation. We would also like to thank the biomedical equipment technicians in our hospital for providing excellent safety and technical support.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission. YS and NY designed the research study, carried out the research, and drafted the manuscript. YS designed the research study. RT, TK, and FT performed the statistical analysis. HI conceived the study, coordination and helped to draft the manuscript.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in thestudy design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. Tolwani AJ, Campbell RC, Stofan BS, Stofan BS, Lai KR, Oster RA, et al. Standard versus high-dose CVVHDF for ICU-related acute renal failure. J Am Soc Nephrol 2008;19:1233–8.10.1681/ASN.2007111173Suche in Google Scholar
2. Sadahiro T, Hirasawa H, Oda S, Shiga H, Nakanishi K, Kitamura N, et al. Usefulness of plasma exchange plus continuous hemodiafiltration to reduce adverse effects associated with plasma exchange in patients with acute liver failure. Crit Care Med 2001;29:1386–92.10.1097/00003246-200107000-00014Suche in Google Scholar
3. Jiang HL, Xue WJ, Li DQ, Yin AP, Yin AP, Xin X, et al. Influence of continuous veno-venous hemofiltration on the course of acute pancreatitis. World J Gastroenterol 2005;11:4815–21.10.3748/wjg.v11.i31.4815Suche in Google Scholar
4. Piccinni P, Dan M, Barbacini S, Carraro R, Lieta E, Marafon S, et al. Early isovolaemic haemofiltration in oliguric patients with septic shock. Intensive Care Med 2006;32:80–6.10.1007/s00134-005-2815-xSuche in Google Scholar
5. Thalhammer F, Schenk P, Burgmann H, El Menyawi I, Hollenstein UM, Rosenkranz AR, et al. Single-dose pharmacokinetics of meropenem during continuous venovenous hemofiltration. Antimicrob Agents Chemother 1998;42:2417–20.10.1128/AAC.42.9.2417Suche in Google Scholar
6. Hayakawa M, Ito Y, Fujita I, Iseki K, Gando S. Pharmacokinetics and the most suitable regimen of panipenem/beta mipron in critically ill patients receiving continuous renal replacement therapy: a pilot study. ASAIO J 2006;52:398–403.10.1097/0.1mat.0000225268.28044.aeSuche in Google Scholar
7. Hidaka S, Goto K, Hagiwara S, Iwasaka H, Noguchi T. Doripenem pharmacokinetics in critically ill patients receiving continuous hemodiafiltration (CHDF). Yakugaku Zasshi 2010;130:87–94.10.1248/yakushi.130.87Suche in Google Scholar
8. Patel IH, Chen S, Parsonnet M, Hackman MR, Brooks MA, Konikoff J, et al. Pharmacokinetics of ceftriaxone in humans. Antimicrob Agents Chemother 1981;20:634–41.10.1128/AAC.20.5.634Suche in Google Scholar
9. Craig WA. Interrelationship between pharmacokinetics and pharmacodynamics in determining dosage regimens for broad-spectrum cephalosporins. Diagn Microbiol Infect Dis 1995;22:89–96.10.1016/0732-8893(95)00053-DSuche in Google Scholar
10. Simon N, Dussol B, Sampol E, Purgus R, Brunet P, Lacarelle B, et al. Population pharmacokinetics of ceftriaxone and pharmacodynamic considerations in haemodialysed patients. Clin Pharmacokinet 2006;45:493–501.10.2165/00003088-200645050-00004Suche in Google Scholar PubMed
11. World Medical Association. Declaration of Helsinki – ethical principles for medical research involving human subjects, Sixth Revision. Ferney-Voltaire, France: World Medical Association, 2008.10.1515/9783110208856.233Suche in Google Scholar
12. Yasuda N, Goto K, Yamamoto S, Hidaka S, Hagiwara S, Noguchi T. Removal of 17 cytokines, HMGB1, and albumin by continuous hemofiltration using a cellulose triacetate membrane: an ex vivo study. J Surg Res 2012;176:226–31.10.1016/j.jss.2011.07.047Suche in Google Scholar PubMed
13. Patel IH, Sugihara JG, Weinfeld RE, Wong EG, Siemsen AW, Berman SJ. Ceftriaxone pharmacokinetics in patients with various degrees of renal impairment. Antimicrob Agents Chemother 1984;25:438–42.10.1128/AAC.25.4.438Suche in Google Scholar PubMed PubMed Central
14. Rowland M, Tozer TN. Clinical pharmacokinetics and pharmacodynamics, 4th ed. Philadelphia: Lippincott Williams & Wilkins, 2011.Suche in Google Scholar
15. Hoffmann-La Roche Inc. ROCEPHIN® (ceftriaxone sodium) FOR INJECTION. Nutley, NJ: Roche Laboratories, 2007.Suche in Google Scholar
16. Suzuki Y, Nishinari C, Endoh H, Tamura C, Jinbo K. Antimicrobiral activities of Ceftriaxone (CTRX) against various clinical isolate strains – antimicrobiral activity profile from 1987 through 2001. J New Remedies Clin 2002;51:971–81 (Japanese).Suche in Google Scholar
17. Garot D, Respaud R, Lnotte P, Simon N, Mercier E, Ehrmann S, et al. Population pharmacokinetics of ceftriaxone in critically ill septic patients: a reappraisal. Br J Clin Pharmacol 2011;72:758–67.10.1111/j.1365-2125.2011.04005.xSuche in Google Scholar PubMed PubMed Central
18. Kroh UF, Lennartz H, Edwards DJ, Stoeckel K. Pharmacokinetics of ceftriaxone in patients undergoing continouous veno-venous hemofiltration. J Clin Pharmacol 1996;36:1114–19.10.1002/j.1552-4604.1996.tb04164.xSuche in Google Scholar PubMed
©2016 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Behavior and Neuroprotection
- Analgesic properties of aqueous leaf extract of Haematostaphis barteri: involvement of ATP-sensitive potassium channels, adrenergic, opioidergic, muscarinic, adenosinergic and serotoninergic pathways
- Correlative study of peripheral ATP1A1 gene expression level to anxiety severity score on major depressive disorder patients
- Comparison of fluoxetine and 1-methyl-L-tryptophan in treatment of depression-like illness in Bacillus Calmette-Guerin-induced inflammatory model of depression in mice
- Reproduction
- Tobacco smoke exposure induces irreversible alteration of testicular function in prepubertal rats
- Oxidative Stress
- α-Lipoic acid attenuates transplacental nicotine-induced germ cell and oxidative DNA damage in adult mice
- Effects of nicotine in the presence and absence of vitamin E on morphology, viability and osteogenic gene expression in MG-63 osteoblast-like cells
- Metabolism
- Age-dependent features of CYP3A, CYP2C, and CYP2E1 functioning at metabolic syndrome
- Exercise increases the level of plasma orexin A in humans
- Inflammation
- Drug combinations in diabetic neuropathic pain: an experimental validation
- Pharmacokinetics of ceftriaxone in patients undergoing continuous renal replacement therapy
- Hematology
- Phenotypic homogeneity with minor deviance in osmotic fragility of Sahel goat erythrocytes in non-ionic sucrose media during various physiologic states
- Protection against arsenic-induced hematological and hepatic anomalies by supplementation of vitamin C and vitamin E in adult male rats
- One more health benefit of blood donation: reduces acute-phase reactants, oxidants and increases antioxidant capacity
- Phytotherapy
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Artikel in diesem Heft
- Frontmatter
- Behavior and Neuroprotection
- Analgesic properties of aqueous leaf extract of Haematostaphis barteri: involvement of ATP-sensitive potassium channels, adrenergic, opioidergic, muscarinic, adenosinergic and serotoninergic pathways
- Correlative study of peripheral ATP1A1 gene expression level to anxiety severity score on major depressive disorder patients
- Comparison of fluoxetine and 1-methyl-L-tryptophan in treatment of depression-like illness in Bacillus Calmette-Guerin-induced inflammatory model of depression in mice
- Reproduction
- Tobacco smoke exposure induces irreversible alteration of testicular function in prepubertal rats
- Oxidative Stress
- α-Lipoic acid attenuates transplacental nicotine-induced germ cell and oxidative DNA damage in adult mice
- Effects of nicotine in the presence and absence of vitamin E on morphology, viability and osteogenic gene expression in MG-63 osteoblast-like cells
- Metabolism
- Age-dependent features of CYP3A, CYP2C, and CYP2E1 functioning at metabolic syndrome
- Exercise increases the level of plasma orexin A in humans
- Inflammation
- Drug combinations in diabetic neuropathic pain: an experimental validation
- Pharmacokinetics of ceftriaxone in patients undergoing continuous renal replacement therapy
- Hematology
- Phenotypic homogeneity with minor deviance in osmotic fragility of Sahel goat erythrocytes in non-ionic sucrose media during various physiologic states
- Protection against arsenic-induced hematological and hepatic anomalies by supplementation of vitamin C and vitamin E in adult male rats
- One more health benefit of blood donation: reduces acute-phase reactants, oxidants and increases antioxidant capacity
- Phytotherapy
- Antithrombotic and cytotoxic activities of four Bangladeshi plants and PASS prediction of their isolated compounds
