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Gentamicin pharmacokinetics during continuous venovenous hemofiltration in critically ill septic patients

N. Petejova, J. Zahalkova, J. Duricova, I. Kacirova, H. Brozmanova, K. Urbanek, M. Grundmann, A. Martinek

. 2012 ; 24 (2) : 107-112.

Jazyk angličtina Země Anglie, Velká Británie

Typ dokumentu časopisecké články, práce podpořená grantem

Perzistentní odkaz   https://www.medvik.cz/link/bmc13000846

Grantová podpora
NS10309 MZ0 CEP - Centrální evidence projektů

OBJECTIVE: Current dosing recommendations for administration of gentamicin to septic patients with acute kidney injury (AKI) on continuous venovenous hemofiltration (CVVH) at a filtration rate of 45 ml/kg/h are missing. AIM: To describe gentamicin pharmacokinetics and to find an optimal dosing regimen in patients on CVVH. METHODS: Seven adult patients were included. Patients received loading dose of 240 mg followed by application of maintenance dose every 24 hours. Maintenance dose was adjusted according to gentamicin C(max)/MIC ratio and drug levels simulation using a pharmacokinetic programme. RESULTS: Median total clearance (0.59-0.79 ml/min/kg) was similar to patients with normal renal function; median volume of distribution was higher than observed in non-septic patients (about 0.5 l/kg versus 0.25 l/kg). Patients with diuresis required an increase of gentamicin dose to reach C(max)/MIC ratio. CONCLUSION: Septic patients with AKI on CVVH (45 ml/kg/h) require a loading dose of 240 mg, followed by therapeutic drug monitoring to optimize maintenance dose.

Citace poskytuje Crossref.org

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