uu.seUppsala universitets publikationer
Ändra sökning
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Challenge for higher colistin dosage in critically ill patients receiving continuous venovenous haemodiafiltration
Hygeia Gen Hosp, Dept Internal Med 6, Athens, Greece.;Hygeia Gen Hosp, 4 Erythrou Stavrou Str & Kifisias, Athens 15123, Greece..
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Farmaceutiska fakulteten, Institutionen för farmaceutisk biovetenskap.
Hygeia Gen Hosp, Dept Internal Med 6, Athens, Greece..
Hygeia Gen Hosp, 4 Erythrou Stavrou Str & Kifisias, Athens 15123, Greece..
Visa övriga samt affilieringar
2016 (Engelska)Ingår i: International Journal of Antimicrobial Agents, ISSN 0924-8579, E-ISSN 1872-7913, Vol. 48, nr 3, s. 337-341Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

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.

Ort, förlag, år, upplaga, sidor
2016. Vol. 48, nr 3, s. 337-341
Nyckelord [en]
Colistin, CMS, Loading dose, Pharmacokinetics, CVHHDF
Nationell ämneskategori
Farmaceutiska vetenskaper Infektionsmedicin
Identifikatorer
URN: urn:nbn:se:uu:diva-308782DOI: 10.1016/j.ijantimicag.2016.06.008ISI: 000386022000018PubMedID: 27474468OAI: oai:DiVA.org:uu-308782DiVA, id: diva2:1054601
Tillgänglig från: 2016-12-08 Skapad: 2016-11-30 Senast uppdaterad: 2018-01-13Bibliografiskt granskad

Open Access i DiVA

Fulltext saknas i DiVA

Övriga länkar

Förlagets fulltextPubMed

Personposter BETA

Friberg, Lena E

Sök vidare i DiVA

Av författaren/redaktören
Friberg, Lena E
Av organisationen
Institutionen för farmaceutisk biovetenskap
I samma tidskrift
International Journal of Antimicrobial Agents
Farmaceutiska vetenskaperInfektionsmedicin

Sök vidare utanför DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetricpoäng

doi
pubmed
urn-nbn
Totalt: 480 träffar
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf