Authors: B Preiswerk A Rudiger J Fehr N Corti
Publish Date: 2012/07/21
Volume: 41, Issue: 2, Pages: 553-557
Abstract
For critically ill patients undergoing continuous renal replacement therapy CRRT daptomycin dosing recommendations are scarce We therefore retrospectively assessed routinely measured daptomycin plasma concentrations daptomycin dose administered and microbiological data in 11 critically ill patients with Grampositive infections that had received daptomycin once dailyDaptomycin dose ranged from 3 to 8 mg/kg/q24 h in patients undergoing CRRT n = 7 and 6 to 10 mg/kg/q24 h in patients without CRRT n = 4 Peak and trough concentrations showed a high intra and interpatient variability in both groups independent of the dosage per kg body weight No drug accumulation was detected in CRRT patients with oncedaily daptomycin dosing Causative pathogens were Enterococcus faecium n = 6 coagulasenegative Staphylococcus n = 2 Staphylococcus aureus n = 2 and unknown in one patient Microbiological eradication was successful in 8 of 11 patients Two of three patients with unsuccessful microbiological eradication and fatal outcome had an Enterococcus faecium infectionIn critically ill patients undergoing CRRT daptomycin exposure with oncedaily dosing was similar to ICU patients with normal renal function but lower compared to healthy volunteers Our data suggest that daptomycin oncedaily dosing is appropriate in patients undergoing CRRT
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