A novel way to investigate the effects of plasma exchange on antibiotic levels: Use of microdialysis

Roberts, Jason A., Roberts, Michael S., Robertson, Thomas A., Cross, Sheree E. and Lipman, Jeffrey (2008) A novel way to investigate the effects of plasma exchange on antibiotic levels: Use of microdialysis. International Journal of Antimicrobial Agents, 31 3: 240-244. doi:10.1016/j.ijantimicag.2007.09.013


Author Roberts, Jason A.
Roberts, Michael S.
Robertson, Thomas A.
Cross, Sheree E.
Lipman, Jeffrey
Title A novel way to investigate the effects of plasma exchange on antibiotic levels: Use of microdialysis
Journal name International Journal of Antimicrobial Agents   Check publisher's open access policy
ISSN 0924-8579
Publication date 2008-03-01
Year available 2007
Sub-type Article (original research)
DOI 10.1016/j.ijantimicag.2007.09.013
Open Access Status Not yet assessed
Volume 31
Issue 3
Start page 240
End page 244
Total pages 5
Editor A. M. Geddes
Place of publication Amsterdam, Netherlands
Publisher Elsevier B.V.
Language eng
Subject C1
110310 Intensive Care
110309 Infectious Diseases
Abstract Plasma exchange (PE) is a treatment modality frequently used for many autoimmune diseases and may cause extracorporeal elimination of antibiotics. No data currently exist on antibiotic concentrations in extracellular fluid during PE. The aim of this study is to describe the effect of PE on the serum and subcutaneous tissue pharmacokinetics of piperacillin administered as a continuous infusion in a critically ill 17-year-old patient with Guillain–Barré syndrome and ventilator-associated pneumonia on Days 1 and 4 of antibiotic therapy. The effect of PE on piperacillin concentrations appears to be small. On Day 1, an estimated 7% of total piperacillin eliminated during PE was attributable to PE. On Day 4 this was estimated to be 11%. Using the in vivo sampling technique microdialysis, we have been able to show that a small redistribution of piperacillin from tissue to serum occurs in response to the reducing serum concentrations caused by PE. In critically ill patients, we believe that administration of a β-lactam antibiotic by continuous infusion should be considered to maintain serum and tissue concentrations of these time-dependent antibiotics.
Keyword Beta-lactam
Piperacillin
Continuous infusion
Plasma exchange
Microdialysis
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
 
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Created: Mon, 13 Apr 2009, 04:37:11 EST by Sia Athanasas on behalf of Anaesthesiology and Critical Care - RBWH