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Daptomycin clearance during modeled continuous renal replacement therapy.

Mariann D Churchwell1, Deborah A Pasko, Bruce A Mueller

  • 1The University of Toledo, College of Pharmacy, Department of Pharmacy Practice, Toledo, Ohio, USA. Mariann.Churchwell@utoledo.edu

Blood Purification
|November 25, 2006
PubMed
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Daptomycin clearance during continuous renal replacement therapy (CRRT) depends on the hemodiafilter type and flow rates. Higher CRRT rates may lead to significant drug removal, impacting dosing.

Area of Science:

  • Pharmacology
  • Nephrology
  • Critical Care Medicine

Background:

  • Pharmacotherapy for critically ill patients on continuous renal replacement therapies (CRRT) is complex due to limited dosing data.
  • Daptomycin dosing requires careful consideration in patients undergoing CRRT.

Purpose of the Study:

  • To assess daptomycin's transmembrane clearance during continuous hemofiltration and hemodialysis.
  • To evaluate the impact of hemodiafilter type and flow rates on daptomycin removal.

Main Methods:

  • An in vitro model was used to assess daptomycin clearance.
  • Two hemodiafilter types (AN69 and polysulfone) were tested at varying ultrafiltrate and dialysate flow rates (1-6 L/h).

Main Results:

Related Experiment Videos

  • Daptomycin sieving coefficients ranged from 0.14-0.20 during hemofiltration and 0.05-0.15 during hemodialysis.
  • Significant differences in transmembrane clearance were observed between filter types and flow rates.
  • AN69 filters showed lower daptomycin clearance than polysulfone filters at higher dialysate flow rates.

    • Conclusions:

    • Daptomycin transmembrane clearance is influenced by hemodiafilter type and CRRT flow rates.
    • High ultrafiltrate or dialysate rates during CRRT can result in substantial daptomycin clearance, necessitating dosage adjustments.