Alteration of the pharmacokinetics of aminoglycosides by adsorption in a filter during continuous renal replacement therapy. An in vitro assessment

Baud, Frédéric J.; Houzé, Pascal; Carli, Pierre; Lamhaut, Lionel

doi:10.1016/j.therap.2020.10.005

Cited by 10 publications

(22 citation statements)

References 35 publications

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“…20 In a previous in vitro study, a cut-off for significance was set at 17%. 21 In previous and the present studies using our in vitro model, 9,17,18,22 the cut-off for significant difference in means was set at 20% to be considered clinically relevant.…”

Section: Methodsmentioning

confidence: 99%

“…A previous study showed that, in the continuous diafiltration mode (CDF), more than 90% of the dose of gentamicin was eliminated within less than 6 h. 9 Therefore, the single exposure experiment was conducted as follows: the 5-L bag of the CC was loaded with gentamicin. The aim of the study was to assess inter-day reproducibility of results regarding the elimination of gentamicin assessed using our in vitro model.…”

Section: Methodsmentioning

confidence: 99%

“…During the session, samplings were performed as previously described. 9,18 Samples were collected in the CC, the inlet ( C si ) and outlet ( C so ) ports of the filter at 0, +15, +45, +60 min and then every hour till 6 h. A sample of cumulative effluent was collected when the 5-L bag was full, and the last cumulative effluent was collected at the time the experiment was stopped.…”

Section: Methodsmentioning

confidence: 99%

“…The routes of elimination were assessed using the NeckEpur ® software as previously reported. 9,17,18…”

Section: Methodsmentioning

confidence: 99%

“…4 In vitro studies evidenced adsorption of tobramycin and amikacin 5 while adsorption of gentamicin by filters was also consistently evidenced. 6–9…”

Section: Introductionmentioning

confidence: 99%

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Elimination of three doses of gentamicin over three consecutive days using a polyacrylonitrile-derived filter: An in vitro assessment

et al. 2021

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Introduction: Adsorption of gentamicin in a polyacrylonitrile filter was previously evidenced in a session lasting 6 h using the NeckEpur model. We extended the study over three consecutive days to mimic the 72-h life span of a filter. Methods: Prismaflex® monitor and ST150® filter were used in the continuous diafiltration (CDF) mode at a 2.5 L/h flowrate. The daily session started with a 6-h session of CDF. Thereafter, the 5-L central compartment was changed using a bag free of gentamicin to assess gentamicin release over the following 18 h. Experiments were repeated on Day 2 and stopped at the end of the 6-h session of CDF on Day 3. The experiment was performed in duplicate. Results: At a 2.5 L/h diafiltration flowrate, the mean daily clearances of gentamicin were 5.5, 4.0, and 3.3 L/h, respectively. The mean diafiltration and adsorption ratios in the daily elimination of gentamicin were 32/68%, 58/42%, and 88/12%, respectively. During days 1 and 2, the mean amount of gentamicin released from the ST150® filter were 14 and 34 mg, respectively. Conclusion: The pharmacokinetics of gentamicin over 3 days is strongly altered by adsorption in the same filter with a progressive decrease of elimination by adsorption, suggesting saturation of the filter. One limitation of our study results from the mode of administration using a bolus dose instead of an infusion over 30 min. Adsorption adds a clearance to those of diafiltration. The time-dependency of gentamicin clearance precludes using a constant dosage regimen over the filter’s life span.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…The routes of elimination were assessed using the NeckEpur ® software as previously reported. 9,17,18…”

Section: Methodsmentioning

confidence: 99%

“…4 In vitro studies evidenced adsorption of tobramycin and amikacin 5 while adsorption of gentamicin by filters was also consistently evidenced. 6–9…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations