High variability of teicoplanin concentration in patients with continuous venovenous hemodiafiltration
Hemodialysis International Feb 08, 2019
Lim SK, et al. - Researchers evaluated the impact of continuous venovenous hemodiafiltration (CVVHDF) on the pharmacokinetics of teicoplanin as maintenance therapy in this prospective observational analysis of 10 samples from 8 patients. Teicoplanin levels were assessed using blood, urine, and dialysate samples. Using simplex-linear modeling, they calculated CVVHDF clearance (CLCVVHDF), total clearance (CLTOTAL), and volume of distribution (Vd). Creatinine clearance was 3.4 ± 5.1 ml/min/1.73 m2 and 32.1 ± 7.0 mL/kg/h was the dose for CVVHDF. Vd was 1.6 ± 0.7 L/kg and T1/2 was 100.1 ± 42.7 hours. CLTOTAL of teicoplanin and CLCVVHDF was 11.9 ± 5.4 mL/min and 5.8 ± 4.2 mL/min, respectively. The observed contribution of CLCVVHDF to CLTOTAL was 51.2% ± 23.6%. There was no impact of CLCVVHDF dose on overall CLTOTAL, Vd, or half-life. Findings revealed great variability in teicoplanin pharmacokinetics among patients receiving CVVHDF, which complicates the empiric approach to dosing and calls for therapeutic drug monitoring.
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