Serum levels of mecillinam in patients with severely impaired renal function

Area of Science:

• Pharmacology
• Nephrology
• Infectious Diseases

Background:

• Urinary tract infections (UTIs) are common, especially in patients with renal insufficiency.
• Mecillinam is an antibiotic used to treat UTIs, but its pharmacokinetics in severe renal insufficiency require further investigation.

Purpose of the Study:

• To evaluate the pharmacokinetic profile and safety of intravenous mecillinam in patients with severe renal insufficiency.
• To determine if mecillinam achieves therapeutic concentrations and a steady state in this patient population.

Main Methods:

• Twelve patients with severe renal insufficiency received 400 mg of mecillinam intravenously every 6 hours.
• Serum concentrations of mecillinam were measured at specific time points.
• Serum half-life and steady-state achievement were analyzed.

Main Results:

• High serum mecillinam concentrations were observed (mean values 11.4 and 14.5 microgram/ml at 6 hours on days 2 and 5).
• The mean serum half-life was 334 minutes, indicating reduced elimination.
• A nearly steady state was achieved within the first few days of treatment.

Conclusions:

• Intravenous mecillinam effectively reaches high serum concentrations in patients with severe renal insufficiency.
• Despite impaired drug elimination, mecillinam can achieve a steady state, suggesting potential therapeutic efficacy.
• Mecillinam was well-tolerated, with no observed side effects in this patient group.