Interaction of ceftazidime and clindamycin with extracorporeal life support

Hunt, J. Porter; McKnite, Autumn M.; Green, Danielle J.; Whelan, Aviva J.; Imburgia, Carina E.; Watt, Kevin M.

doi:10.1016/j.jiac.2023.08.007

Journal of Infection and Chemotherapy

2023

DOI: 10.1016/j.jiac.2023.08.007

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Interaction of ceftazidime and clindamycin with extracorporeal life support

J. Porter Hunt,

Autumn M. McKnite,

Danielle J. Green

et al.

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2024

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Cited by 5 publications

References 32 publications

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Dynamic interaction of antibiotic resistance between plant microbiome and organic fertilizers: sources, dissemination, and health risks

Ullah,

Hassan,

Yang

et al. 2024

World J Microbiol Biotechnol

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Dynamic interaction of antibiotic resistance between plant microbiome and organic fertilizers: sources, dissemination, and health risks

Ullah,

Hassan,

Yang

et al. 2024

World J Microbiol Biotechnol

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Interaction of milrinone with extracorporeal life support

Whelan,

Mim,

Hunt

et al. 2024

J Extra Corpor Technol

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Background: Milrinone is commonly prescribed to critically ill patients that need extracorporeal life support such as ECMO and CRRT. Currently, the effect of ECMO and CRRT on the disposition of milrinone is unknown. Methods: Ex vivo ECMO and CRRT circuits were primed with human blood, then dosed with milrinone to study drug extraction by the circuits. Milrinone percent recovery over time was calculated to determine circuit component interaction with milrinone. Results : Milrinone did not exhibit measurable interactions with the ECMO circuit, however CRRT cleared 99% of milrinone from the experimental circuit within the first 2 hours. Conclusion: Milrinone dosing adjustments are likely required in patients who are supported with CRRT, while dosing adjustments for ECMO based off these ex-vivo results are likely unnecessary. These results will help improve the safety and efficacy of milrinone in patients requiring ECMO and CRRT. Due to limitations of ex-vivo experiments, future studies of milrinone exposure with ECLS should include patient circuit interactions as well as physiology of critical illness.

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Extraction of ketamine and dexmedetomidine by extracorporeal life support circuits

Chevalier,

Porter Hunt,

Whelan

et al. 2024

J Extra Corpor Technol

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Background: Patients supported with extracorporeal life support (ECLS) circuits such as ECMO and CRRT often require high doses of sedatives and analgesics, including ketamine and dexmedetomidine. Concentrations of many medications are affected by ECLS circuits through adsorption to the circuit components, dialysis, as well as the large volume of blood used to prime the circuits. However, the impact of ECLS circuits on ketamine and dexmedetomidine pharmacokinetics has not been well described. This study determined ketamine and dexmedetomidine extraction by extracorporeal circuits in an ex-vivo system. Methods: Medication was administered at therapeutic concentration to blood-primed, closed-loop ex-vivo ECMO and CRRT circuits. Drug concentrations were measured in plasma, hemofiltrate, and control samples at multiple time points throughout the experiments. At each sample time point, the percentage of drug recovery was calculated. Results: Ketamine plasma concentration in the ECMO and CRRT circuits decreased rapidly, with 43.8% recovery (SD = 0.6%) from ECMO circuits after 8 h and 3.3% (SD = 1.8%) recovery from CRRT circuits after 6 h. Dexmedetomidine was also cleared from CRRT circuits, with 20.3% recovery (SD = 1.8%) after 6 h. Concentrations of both medications were very stable in the control experiments, with approximately 100% drug recovery of both ketamine and dexmedetomidine after 6 h. Conclusion: Ketamine and dexmedetomidine concentrations are significantly affected by ECLS circuits, indicating that dosing adjustments are needed for patients supported with ECMO and CRRT.

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Interaction of ceftazidime and clindamycin with extracorporeal life support

Cited by 5 publications

References 32 publications

Dynamic interaction of antibiotic resistance between plant microbiome and organic fertilizers: sources, dissemination, and health risks

Dynamic interaction of antibiotic resistance between plant microbiome and organic fertilizers: sources, dissemination, and health risks

Interaction of milrinone with extracorporeal life support

Extraction of ketamine and dexmedetomidine by extracorporeal life support circuits

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