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Pharmacokinetics and pharmacodynamics of anti-infective agents during continuous veno-venous hemofiltration in critically ill patients: Lessons learned from an ancillary study of the IVOIRE trial

dc.rights.licenseopenen_US
hal.structure.identifierBiologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
dc.contributor.authorBREILH, Dominique
dc.contributor.authorHONORE, Patrick M.
dc.contributor.authorDE BELS, David
dc.contributor.authorROBERTS, Jason A.
hal.structure.identifierBiologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
dc.contributor.authorGORDIEN, Jean Baptiste
dc.contributor.authorFLEUREAU, Catherine
dc.contributor.authorDEWITTE, Antoine
dc.contributor.authorCOQUIN, Julien
dc.contributor.authorROZÉ, Hadrien
dc.contributor.authorPEREZ, Paul
dc.contributor.authorATTOU, Rachid
dc.contributor.authorREDANT, Sebastien
dc.contributor.authorKUGENER, Luc
hal.structure.identifierBiologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
dc.contributor.authorSAUX, Marie-Claude
dc.contributor.authorSPAPEN, Herbert D.
hal.structure.identifierBiologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
dc.contributor.authorOUATTARA, Alexandre
dc.contributor.authorJOANNES-BOYAU, Olivier
dc.date.accessioned2020-11-10T11:24:09Z
dc.date.available2020-11-10T11:24:09Z
dc.date.issued2019-12
dc.identifier.issn2224-4018en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/12198
dc.description.abstractEnAbstract Background Hemofiltration rate, changes in blood and ultrafiltration flow, and discrepancies between the prescribed and administered doses strongly influence pharmacokinetics (PK) and pharmacodynamics (PD) of antimicrobial agents during continuous veno-venous hemofiltration (CVVH) in critically ill patients. Methods Ancillary data were from the prospective multicenter IVOIRE (hIgh VOlume in Intensive caRE) study. High volume (HV, 70 mL/kg/h) was at random compared with standard volume (SV, 35 mL/kg/h) CVVH in septic shock patients with acute kidney injury (AKI). PK/PD parameters for all antimicrobial agents used in each patient were studied during five days. Results Antimicrobial treatment met efficacy targets for both percentage of time above the minimal inhibitory concentration and inhibitory quotient. A significant correlation was observed between the ultrafiltration flow and total systemic clearance (Spearman test: P \textless 0.005) and between CVVH clearance and drug elimination half-life (Spearman test: P \textless 0.005). All agents were easily filtered. Mean sieving coefficient ranged from 38.7% to 96.7%. Mean elimination half-life of all agents was significantly shorter during HV-CVVH (from 1.29 to 28.54 h) than during SV-CVVH (from 1.51 to 33.85 h) ( P \textless 0.05). Conclusions This study confirms that CVVH influences the PK/PD behavior of most antimicrobial agents. Antimicrobial elimination was directly correlated with convection rate. Current antimicrobial dose recommendations will expose patients to underdosing and increase the risk for treatment failure and development of resistance. Dose recommendations are proposed for some major antibiotic and antifungal treatments in patients receiving at least 25 mL/kg/h CVVH.
dc.language.isoENen_US
dc.subjectArticle RECHERCHE
dc.title.enPharmacokinetics and pharmacodynamics of anti-infective agents during continuous veno-venous hemofiltration in critically ill patients: Lessons learned from an ancillary study of the IVOIRE trial
dc.typeArticle de revueen_US
dc.identifier.doi10.2478/jtim-2019-0031en_US
dc.subject.halSciences du Vivant [q-bio]/Médecine humaine et pathologieen_US
bordeaux.journalJournal of Translational Internal Medicineen_US
bordeaux.page155–169en_US
bordeaux.volume7en_US
bordeaux.hal.laboratoriesBiologie des maladies cardiovasculaires - U1034en_US
bordeaux.issue4en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.identifierinserm-03627912
hal.version1
hal.exportfalse
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