Removal of linezolid by conventional intermittent hemodialysis, sustained low-efficiency dialysis, or continuous venovenous hemofiltration in patients with acute renal failure
- 1 December 2004
- journal article
- research article
- Published by Wolters Kluwer Health in Critical Care Medicine
- Vol. 32 (12), 2437-2442
- https://doi.org/10.1097/01.ccm.0000147687.06808.92
Abstract
To study the removal of linezolid, a new oxazolidinone antibiotic, by renal replacement therapy in patients with acute renal failure. Prospective, single-dose pharmacokinetic study. Renal intensive care unit of a tertiary university hospital. Fifteen critically ill patients with oliguric acute renal failure on renal replacement therapy (seven males, mean age 72.3 yrs, range 60–94; Acute Physiology and Chronic Health Evaluation II score 24.9, range 18–36; mechanical ventilation ten of 15). All patients received 600 mg of intravenous linezolid before starting renal replacement therapy, which consisted of intermittent hemodialysis lasting 3–4 hrs in eight patients, sustained low-efficiency dialysis lasting 8 hrs in five patients, and continuous venovenous hemofiltration lasting 10.5–12 hrs in two patients. Linezolid concentrations were measured by liquid chromatography/mass spectrometry methods on serum and dialysate/ultrafiltrate samples. At the start of renal replacement therapy, serum levels averaged 11.91 mg/L (range 5.49–21.52) and dropped at the end to levels <4 mg/dL (90% minimum inhibitory concentration values for Staphylococcus aureus) in three of eight patients on hemodialysis, three of five patients on sustained low-efficiency dialysis, and two of two patients on continuous venovenous hemofiltration. Mean removal of the drug was 193.7 mg with hemodialysis (32.3% of the dose administered), 205 mg with sustained low-efficiency dialysis (33.9%), and 74.8 mg (12.4%) and 105 (17.5%) mg following a continuous venovenous hemofiltration session lasting 10.5 and 12 hrs, respectively. In patients with acute renal failure, serum levels of linezolid can be reduced to the subtherapeutic range following renal replacement therapy.Keywords
This publication has 16 references indexed in Scilit:
- Peritoneal dialysis fluid concentrations of linezolid in the treatment of vancomycin-resistant Enterococcus faecium peritonitis.Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 2003
- Pharmacokinetics of Linezolid in Subjects with Renal DysfunctionAntimicrobial Agents and Chemotherapy, 2003
- Linezolid Clearance During Continuous Venovenous Hemodiafiltration: A Case ReportPharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 2003
- Pharmacokinetic and pharmacodynamic profile of linezolid in healthy volunteers and patients with Gram-positive infectionsJournal of Antimicrobial Chemotherapy, 2003
- Linezolid: The First Oxazolidinone AntimicrobialAnnals of Internal Medicine, 2003
- Clinical Pharmacokinetics of Linezolid, a Novel Oxazolidinone AntibacterialClinical Pharmacokinetics, 2003
- Linezolid for treatment of vancomycin-resistant enterococcal peritonitisAmerican Journal of Kidney Diseases, 2001
- Establishing MIC breakpoints and the interpretation of in vitro susceptibility testsJournal of Antimicrobial Chemotherapy, 2001
- Survival on hemodialysis and peritoneal dialysis over 12 years with emphasis on nutritional parametersAmerican Journal of Kidney Diseases, 2001
- Dialysate-Based Kinetic ModelingAdvances in Renal Replacement Therapy, 1995