Elimination of cefmenoxime during continuous haemofiltration

Area of Science:

• Pharmacokinetics
• Nephrology
• Infectious Diseases

Background:

• Severe renal failure and sepsis significantly alter drug pharmacokinetics.
• Continuous hemofiltration is a common renal replacement therapy in critically ill patients.

Purpose of the Study:

• To investigate the elimination of cefmenoxime in patients with severe renal failure and sepsis undergoing continuous hemofiltration.
• To determine appropriate cefmenoxime dosing strategies for this patient population.

Main Methods:

• Studied cefmenoxime elimination in 12 patients with severe renal failure and sepsis during continuous hemofiltration.
• Measured drug concentrations in filtrate and plasma to calculate sieving coefficient, volume of distribution, half-life, and total clearance.

Main Results:

• Over 30% of cefmenoxime was eliminated via hemofiltration, with a sieving coefficient of 0.54.
• Volume of distribution remained unchanged, but the mean half-life prolonged to approximately 16 hours.
• Total clearance was significantly reduced to 20.8 ml/min/1.73 m².

Conclusions:

• Continuous hemofiltration effectively removes cefmenoxime.
• Dosing adjustments are necessary in patients with severe renal failure and sepsis undergoing hemofiltration.
• A once-daily administration of 1 g cefmenoxime is suggested as an appropriate dose.