PMID- 17356270
OWN - NLM
STAT- MEDLINE
DCOM- 20070501
LR  - 20181201
IS  - 1421-9794 (Electronic)
IS  - 0009-3157 (Linking)
VI  - 53
IP  - 3
DP  - 2007
TI  - In vitro AN69 and polysulphone membrane permeability to ceftazidime and in vivo 
      pharmacokinetics during continuous renal replacement therapies.
PG  - 194-201
AB  - BACKGROUND: Ceftazidime is a third-generation cephalosporin almost entirely 
      eliminated by glomerular filtration and dose reductions are essential in patients 
      with renal impairment. The physicochemical and pharmacokinetic properties of 
      ceftazidime make it susceptible to be eliminated by continuous renal replacement 
      therapies (CRRT), but there is little clinical information to guide the correct 
      administration in patients undergoing these techniques. METHODS: In vitro 
      procedures were carried out in three different fluids, using AN69 or polysulphone 
      membranes. Four patients entered the in vivo study. Two patients received 1,000 
      mg every 6 h and the other two 2,000 mg every 6 h. Concentrations of ceftazidime 
      were measured by high-performance liquid chromatography. RESULTS: No differences 
      were detected in thesieving coefficients (Sc) or saturation coefficients 
      (Sa)between membranes during continuous venovenous hemofiltration (CVVH) or 
      continuous venovenous hemodiafiltration (CVVHD). Sc-Sa values were close to 1 
      when Ringer's lactate was used as ceftazidime vehicle, but were lower in plasma 
      samples (p < 0.05). In patients, the Sc-Sa was 0.93 +/- 0.06 and correlated well 
      with the unbound fraction (0.86 +/- 0.08). The contribution of CRRT to 
      ceftazidime clearance was higher in anuric patients than in nonanuric patients. 
      CONCLUSIONS: No differences were shown in vitro in the Sc obtained with both 
      membranes during CVVH or the Sa obtained during CVVHD. The contribution of 
      clearance by CRRT to total clearance is clearly dependent on the renal function. 
      The administration of ceftazidime every 6 h could be associated with 
      unnecessarily high trough levels which increase the risk of drug nephrotoxicity. 
      Nonanuric patients undergoing CRRT need higher ceftazidime doses to reach 
      adequate plasma concentrations against pathogens isolated in the critically ill.
CI  - Copyright 2007 S. Karger AG, Basel.
FAU - Isla, Arantxazu
AU  - Isla A
AD  - Laboratory of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, 
      University of the Basque Country, Vitoria-Gasteiz, Spain.
FAU - Gascon, Alicia R
AU  - Gascon AR
FAU - Maynar, Javier
AU  - Maynar J
FAU - Arzuaga, Alazne
AU  - Arzuaga A
FAU - Sanchez-Izquierdo, Jose Antonio
AU  - Sanchez-Izquierdo JA
FAU - Pedraz, Jose Luis
AU  - Pedraz JL
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20070314
PL  - Switzerland
TA  - Chemotherapy
JT  - Chemotherapy
JID - 0144731
RN  - 0 (Acrylic Resins)
RN  - 0 (Albumins)
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Isotonic Solutions)
RN  - 0 (Membranes, Artificial)
RN  - 0 (Polymers)
RN  - 0 (Ringer's Lactate)
RN  - 0 (Sulfones)
RN  - 25135-51-7 (polysulfone P 1700)
RN  - 60650-36-4 (AN-69)
RN  - 9M416Z9QNR (Ceftazidime)
RN  - MP1U0D42PE (Acrylonitrile)
SB  - IM
MH  - *Acrylic Resins
MH  - Acrylonitrile/*analogs & derivatives
MH  - Adult
MH  - Albumins
MH  - Anti-Bacterial Agents/*pharmacokinetics
MH  - Ceftazidime/*pharmacokinetics
MH  - *Hemodiafiltration
MH  - *Hemofiltration
MH  - Humans
MH  - Isotonic Solutions
MH  - Kidney Diseases/metabolism/therapy
MH  - Male
MH  - Membranes, Artificial
MH  - Middle Aged
MH  - Permeability
MH  - Plasma
MH  - *Polymers
MH  - Ringer's Lactate
MH  - *Sulfones
EDAT- 2007/03/16 09:00
MHDA- 2007/05/02 09:00
CRDT- 2007/03/16 09:00
PHST- 2005/02/28 00:00 [received]
PHST- 2006/04/24 00:00 [accepted]
PHST- 2007/03/16 09:00 [pubmed]
PHST- 2007/05/02 09:00 [medline]
PHST- 2007/03/16 09:00 [entrez]
AID - 000100864 [pii]
AID - 10.1159/000100864 [doi]
PST - ppublish
SO  - Chemotherapy. 2007;53(3):194-201. doi: 10.1159/000100864. Epub 2007 Mar 14.