In-vitro adsorption and sieving coefficient of ticarcillin-clavulanate during continuous haemofiltration
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AbstractThere are very limited data on ticarcillin-clavulanate elimination by haemofiltration. We measured in vitro ticarcillin-clavulanate adsorption to polyacrylonitrile filters and the sieving coefficient, using a well-described bench model of haemofiltration. The dose of ticarcillin-clavulate was 60/2 mg or 180/3 mg and 0 or 12 g albumin was added to the 1 l of circulating blood-crystalloid mixture to produce 4 different experimental conditions. The experiment was repeated four times under each condition. Median (IQR) ticarcillin adsorption varied from 28 (27-30) mg to 85 (78-90) mg. Adsorption was increased when the dose of ticarcillin was higher (p<0.001), but was not affected by the addition of albumin. Median (IQR) adsorption of clavulanate ranged from 0.67 (0.55-0.75) mg to 1.8 (0.33-3.5) mg and was neither dose dependent (p=0.505) nor significantly affected by the addition of albumin. Median (IQR) ticarcillin sieving coefficient ranged from 0.73 (0.67-0.75) to 0.99 (0.97-1.03). It was significantly higher with a higher dose of ticarcillin (p=0.021) and without addition of albumin (p=0.015). Median (IQR) clavulanate sieving coefficient ranged from 1.03 (1.00-2.24) to 2.0 (1.98-2.47). Clavulanate sieving coefficient was not significantly affected by dose or the addition of albumin. These data suggest that significant adsorption of both ticarcillin and clavulanate occurs in vitro, however this requires confirmation by clinical pharmacokinetic studies. The sieving coefficient data may help guide appropriate dosing of critically ill patients receiving haemofiltration until more extensive clinical pharmacokinetic data are available.
Acceptance Date21/03/2019
All Author(s) ListWan W, Guerra Valero Y, Choi GY, Ordóñez Mejia JL, Wallis SC, Joynt GM, Lipman J, Gomersall CD, Roberts JA
Journal nameInternational Journal of Antimicrobial Agents
Year2019
Month8
Volume Number54
Issue Number2
PublisherElsevier
Pages261 - 264
ISSN0924-8579
eISSN1872-7913
LanguagesEnglish-United Kingdom
KeywordsClavulanic acid, Ticarcillin, Renal replacement therapy, Critical illness, Pharmacokinetics

Last updated on 2020-24-11 at 01:45