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Table 3 Pharmacokinetic and pharmacodynamic data and characteristics of continuous renal replacement therapy (CRRT)

From: β-lactam antibiotic concentrations during continuous renal replacement therapy

Time from start of antibiotic to sampling, days

Early TDM (n = 35) 2 (1–2]

Late TDM (n = 38) 5 (3–14]

 

CEF (n = 3)

MEM (n = 25)

TZP (n = 7)

CEF (n = 6)

MEM (n = 19)

TZP (n = 13)

Volume of distribution, L

19.4 (15.8 to 23.1)

33.3 (9.2 to 86.5)

18.5 (11.5 to 61.3)

19.2 (11.4 to 32.9)

28.8 (17.26 to 83.78)

18.2 (7.94 to 52.80)

Volume of distribution, L/kg

0.26 (0.24 to 0.28)

0.39 (0.11 to 1.20)

0.24 (0.17 to 0.87)

0.21 (0.16 to 0.51)

0.37 (0.23 to 1.18)

0.22 (0.11 to 0.76)

t 1/2 , h

4.3 (1.5 to 9.7)

3.9 (1.8 to 22.8)

3.0 (1.5 to 61.3)

8.0 (6.0 to 35.3)*

3.6 (1.8 to 10.7)

4.8 (1.8 to 7.8)

Drug clearance, mL/h

52.4 (27.3 to 120.9)

72.3 (21.4 to 283.0)

54.0 (47.3 to 185.6)

23.3 (5.4 to 58.5)*

98.3 (21.6 to 174.1)

51.0 (16.1 to 140.83)

Concentration at T0, mg/L

28.2 (26.1 to 49.0)

7.7 (2.0 to 32.2)

63.2 (15.3 to 115.2)

64.3 (3.2 to 139.0)*

6.8 (2.7 to 23.2)

80.0 (19.5 to 243.0)

Concentration at T2, mg/L

74.5 (52.0 to 75.0)

21.6 (7.8 to 80.2)

89.5 (55.0 to 211.0)

93.4 (50.5 to 165.0)

22.1 (12.9 to 37.0)

168.4 (49.0 to 395.0)

Concentration at target, mg/L

41.6 (34.3 to 58.2)

18.6 (6.1 to 41.0)

82.0 (43.0 to 174.8)

79.3 (9.6 to 202.0)*

16.1 (9.6 to 30.5)

140.0 (42.0 to 349.0)*

T >4 × tMIC, h

7.2 (6.2 to 14.0)

7.0 (4.5 to 11.8)

6.3 (1.0 to 7.7)

15.5 (6.8 to 55.8)

7.1 (6.0 to 11.3)

7.7 (6.1 to 12.4)

Adequate concentrations

3 (100%)

9 (36%)

1 (14.3%)

1 (16.7%)

9 (47.4%)

3 (23.1%)

Excessive concentrations

0 (0%)

15 (60%)

3 (42.9%)

4 (66.7%)

10 (52.6%)

9 (69.2%)

SOFA score

11 (4 to 14)

14 (4 to 19)

12 (5 to 16)

12 (9 to 13)

12 (5 to 20)

13 (9 to 22)

CRRT blood flow, mL/minute

140 (130 to 150)

150 (130 to 200)

150 (140 to 180)

140 (100 to 200)

150 (120 to 300)

150 (100 to 180)

Dialysate, mL/h

0 (0 to 1,500)

1,500 (0 to 2,000)

1,500 (0 to 2,000)

0 (0 to 1,500)

1,000 (0 to 2,000)

0 (0 to 2,000)

Ultrafiltrate, mL/h

1,000 (1,000 to 1,750)

2,000 (100 to 2,000)

1,500 (1,500 to 2,000)

1,500 (1,000 to 3,000)

1,500 (100 to 2,000)

2,000 (1,500 to 2,000)

CRRT intensity, mL/kg/h

16.6 (10.5 to 47.7)

36.14 (8.9 to 57.14)

31.5 (15.7 to 57.5)

24.0 (16.6 to 50)

34.2 (16.6 to 85.1)

28.6 (21.4 to 61.5)

  1. The results are presented as median (25th to 75th percentiles for time to sampling) and ranges for all pharmacodynamics and continuous renal replacement therapy (CRRT) data.
  2. *P <0.05. TDM, therapeutic drug monitoring; CEF, ceftazidime or cefepime; MEM, meropenem; TZP, piperacillin/tazobactam; SOFA, sepsis organ failure assessment; t1/2, half-life time; T0, trough concentration; T2, concentration 2 h after the onset of drug administration; T >4 × tMIC, time above four times the target minimum inhibitory concentration for P. aeruginosa.