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Removal of Meropenem and Piperacillin during Experimental Hemoadsorption with the HA380 Cartridge

Taku Furukawa1, Yugeesh Lankadeva2,3,4, Ian Baldwin5

  • 1Preclinical Critical Care Unit, Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Victoria, Australia, taku.furukawa@florey.edu.au.

Blood Purification
|November 4, 2024
PubMed
Abstract

Insights

Hemoadsorption using the HA380 cartridge significantly removed meropenem and piperacillin in sepsis models. Dosing adjustments may be needed to prevent underdosing during therapy.

Area of Science:

  • Pharmacokinetics and Pharmacodynamics
  • Critical Care Medicine
  • Nephrology and Critical Care

Background:

  • Hemoadsorption is an adjunctive therapy for sepsis.
  • Limited data exists on antibiotic removal during hemoadsorption.
  • This study investigates meropenem and piperacillin removal by the HA380 cartridge.

Purpose of the Study:

  • To evaluate the efficacy of the HA380 hemoadsorption cartridge in removing meropenem and piperacillin.
  • To determine the removal ratio, clearance, and mass removal of these antibiotics during hemoadsorption.
  • To provide data for optimizing antibiotic dosing in septic patients undergoing hemoadsorption.

Main Methods:

  • A preclinical in vivo study using healthy adult sheep (n=6).
  • Administration of meropenem (2g) and piperacillin (4g) intravenously.
  • Hemoadsorption with HA380 cartridge at 120 mL/min for 4 hours.

Main Results:

  • The HA380 cartridge demonstrated significant removal of both meropenem and piperacillin.
  • Meropenem removal ratio decreased from 95.4% to <20% over 4 hours.
  • Piperacillin removal ratio decreased from 98.4% to 37.4% over 4 hours, with significantly higher clearance than meropenem.
  • Majority of antibiotic removal occurred within the first hour of hemoadsorption.

Conclusions:

  • Hemoadsorption with the HA380 cartridge effectively removes meropenem and piperacillin.
  • High initial antibiotic clearance necessitates consideration of increased antibiotic doses (15-25%) in septic patients to prevent underdosing.
  • Findings inform dosing strategies for concurrent antibiotic and hemoadsorption therapy.
Keywords:
AntibioticsHA380 Jafron cartridgeHemoadsorptionMeropenemPiperacillinSepsisTazocin

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