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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 ...

  • Elsevier BV,2016
  • printrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:uu-308782
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-308782URI
  • https://doi.org/10.1016/j.ijantimicag.2016.06.008DOI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

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Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • 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.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Friberg, Lena EUppsala universitet,Institutionen för farmaceutisk biovetenskap(Swepub:uu)lenasimo (författare)
  • Galani, LambriniHygeia Gen Hosp, Dept Internal Med 6, Athens, Greece. (författare)
  • Ioannidis, KonstantinosHygeia Gen Hosp, 4 Erythrou Stavrou Str & Kifisias, Athens 15123, Greece. (författare)
  • Katsouda, EmmanouelaHygeia Gen Hosp, Intens Care Unit, Athens, Greece. (författare)
  • Athanassa, ZoeHygeia Gen Hosp, Intens Care Unit, Athens, Greece. (författare)
  • Paskalis, HarrisHygeia Gen Hosp, Intens Care Unit, Athens, Greece. (författare)
  • Giamarellou, HelenHygeia Gen Hosp, Dept Internal Med 6, Athens, Greece. (författare)
  • 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

  • Ingår i:International Journal of Antimicrobial Agents: Elsevier BV48:3, s. 337-3410924-85791872-7913

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