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Challenge for highe...
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Karaiskos, IliasHygeia Gen Hosp, Dept Internal Med 6, Athens, Greece.;Hygeia Gen Hosp, 4 Erythrou Stavrou Str & Kifisias, Athens 15123, Greece.
(författare)
Challenge for higher colistin dosage in critically ill patients receiving continuous venovenous haemodiafiltration
- Artikel/kapitelEngelska2016
Förlag, utgivningsår, omfång ...
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Elsevier BV,2016
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printrdacarrier
Nummerbeteckningar
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LIBRIS-ID:oai:DiVA.org:uu-308782
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-308782URI
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https://doi.org/10.1016/j.ijantimicag.2016.06.008DOI
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Språk:engelska
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Sammanfattning på:engelska
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
Anmärkningar
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Traditionally, reduced daily doses of colistin methanesulphonate (CMS) in critically ill patients receiving continuous venovenous haemodiafiltration (CVVHDF) have resulted in suboptimal colistin concentrations. The necessity of a loading dose (LD) at treatment initiation has been proposed. A LD of 9 million IU (MU) [ca. 270 mg of colistin base activity (CBA)] was administrated with a maintenance dose of 4.5 MU (ca. 140 mg CBA) every 12 h (q12h) to eight critically ill patients receiving renal replacement therapy. Blood samples were collected immediately before and at different time intervals after the LD and the fourth dose, whilst pre-filter and post-filter blood samples were also collected. CMS and colistin concentrations were determined using an LC-MS/MS assay. Median maximum observed concentrations after the LD were 22.1 mg/L for CMS and 1.55 mg/L for colistin, whereas during maintenance dosing the corresponding values were 12.6 mg/L and 1.72 mg/L, respectively. CVVHDF clearance was determined as 2.98 L/h for colistin, equivalent to 62% of total apparent colistin clearance in CVVHDF patients. Both CMS and colistin were cleared by CVVHDF. Application of a LD of 9 MU CMS resulted in more rapid achievement of the target colistin concentration. Following implementation of a predicted pharmacokinetic model on plasma CMS/colistin concentrations, a LD of 12 MU CMS appears more appropriate, whilst a CMS maintenance dosage of at least 6.5-7.5 MU q12h is suggested in patients undergoing CVVHDF. However, further clinical studies are warranted to assess the safety of a LD of 12 MU CMS in patients receiving CVVHDF.
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Biuppslag (personer, institutioner, konferenser, titlar ...)
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Friberg, Lena EUppsala universitet,Institutionen för farmaceutisk biovetenskap(Swepub:uu)lenasimo
(författare)
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Galani, LambriniHygeia Gen Hosp, Dept Internal Med 6, Athens, Greece.
(författare)
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Ioannidis, KonstantinosHygeia Gen Hosp, 4 Erythrou Stavrou Str & Kifisias, Athens 15123, Greece.
(författare)
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Katsouda, EmmanouelaHygeia Gen Hosp, Intens Care Unit, Athens, Greece.
(författare)
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Athanassa, ZoeHygeia Gen Hosp, Intens Care Unit, Athens, Greece.
(författare)
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Paskalis, HarrisHygeia Gen Hosp, Intens Care Unit, Athens, Greece.
(författare)
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Giamarellou, HelenHygeia Gen Hosp, Dept Internal Med 6, Athens, Greece.
(författare)
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Hygeia Gen Hosp, Dept Internal Med 6, Athens, Greece.;Hygeia Gen Hosp, 4 Erythrou Stavrou Str & Kifisias, Athens 15123, Greece.Institutionen för farmaceutisk biovetenskap
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:International Journal of Antimicrobial Agents: Elsevier BV48:3, s. 337-3410924-85791872-7913
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