“CATCH” Study: Correct Antibiotic Therapy in Continuous Hemofiltration in the Critically Ill in Continuous Renal Replacement Therapy: A Prospective Observational Study
The proper posology of antibiotics in the critically ill in CRRT is difficult to assess. We therefore performed a prospective observational cohort study to make clear hints in this topic. Our results reveal a high Sieving Coefficient for all antibiotics, equal to or higher than those described in pr...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-12-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/11/12/1811 |
| _version_ | 1797461788151775232 |
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| author | Alberto Corona Alice Veronese Silvia Santini Dario Cattaneo |
| author_facet | Alberto Corona Alice Veronese Silvia Santini Dario Cattaneo |
| author_sort | Alberto Corona |
| collection | DOAJ |
| description | The proper posology of antibiotics in the critically ill in CRRT is difficult to assess. We therefore performed a prospective observational cohort study to make clear hints in this topic. Our results reveal a high Sieving Coefficient for all antibiotics, equal to or higher than those described in previous papers. CVVH clearance in relation to total body clearance was significant, (i.e., >than 25% for all classes). A strong correlation between the antibiotic concentrations obtained in plasma and ultrafiltrate was found both at the peak and in the valley, with the determination of two equations that allow a new method for calculating the amount of antibiotic lost in CVVH both for trough levels and peak. Based on the results of our study and considering the limitations we believe that we can extrapolate the following final considerations: (1) it is likely to carry out a loading dose for the main antibiotics (2) subsequent administrations must take into account the daily loss identified by the linear regression equation. This angular coefficient gives the idea that the average daily loss of given antibiotic is about 25%; this implies that on the basis of the linear regression equation that correlates ultrafiltered/plasma antibiotic concentration, the dosage should be increased by 25% every day, while still ensuring a daily plasma TDM of the drug. |
| first_indexed | 2024-03-09T17:24:20Z |
| format | Article |
| id | doaj.art-b86db3eb7a6144928cefe7313f844c94 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-09T17:24:20Z |
| publishDate | 2022-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-b86db3eb7a6144928cefe7313f844c942023-11-24T12:54:49ZengMDPI AGAntibiotics2079-63822022-12-011112181110.3390/antibiotics11121811“CATCH” Study: Correct Antibiotic Therapy in Continuous Hemofiltration in the Critically Ill in Continuous Renal Replacement Therapy: A Prospective Observational StudyAlberto Corona0Alice Veronese1Silvia Santini2Dario Cattaneo3Accident & Emergency and Anaesthesia and Intensive Care Medicine Department, Esine and Edolo Hospitals, ASST Valcamonica, 25040 Brescia, ItalyIntensive Care Unit, ASST Fatebenefratelli Sacco, Polo Universitario, Via GB Grassi 74, PO Luigi Sacco, 20157 Milano, ItalyIntensive Care Unit, ASST Ovest Milanese, Via Giovanni Paolo II, 20025 Legnano, ItalyUnit of Clinical Pharmacology, ASST Fatebenefratelli Sacco University Hospital, Via GB Grassi 74, 20157 Milan, ItalyThe proper posology of antibiotics in the critically ill in CRRT is difficult to assess. We therefore performed a prospective observational cohort study to make clear hints in this topic. Our results reveal a high Sieving Coefficient for all antibiotics, equal to or higher than those described in previous papers. CVVH clearance in relation to total body clearance was significant, (i.e., >than 25% for all classes). A strong correlation between the antibiotic concentrations obtained in plasma and ultrafiltrate was found both at the peak and in the valley, with the determination of two equations that allow a new method for calculating the amount of antibiotic lost in CVVH both for trough levels and peak. Based on the results of our study and considering the limitations we believe that we can extrapolate the following final considerations: (1) it is likely to carry out a loading dose for the main antibiotics (2) subsequent administrations must take into account the daily loss identified by the linear regression equation. This angular coefficient gives the idea that the average daily loss of given antibiotic is about 25%; this implies that on the basis of the linear regression equation that correlates ultrafiltered/plasma antibiotic concentration, the dosage should be increased by 25% every day, while still ensuring a daily plasma TDM of the drug.https://www.mdpi.com/2079-6382/11/12/1811pharmacodinamicparmacokinenticsantibioticacute kidney failurecritically ill patientsCVVH |
| spellingShingle | Alberto Corona Alice Veronese Silvia Santini Dario Cattaneo “CATCH” Study: Correct Antibiotic Therapy in Continuous Hemofiltration in the Critically Ill in Continuous Renal Replacement Therapy: A Prospective Observational Study Antibiotics pharmacodinamic parmacokinentics antibiotic acute kidney failure critically ill patients CVVH |
| title | “CATCH” Study: Correct Antibiotic Therapy in Continuous Hemofiltration in the Critically Ill in Continuous Renal Replacement Therapy: A Prospective Observational Study |
| title_full | “CATCH” Study: Correct Antibiotic Therapy in Continuous Hemofiltration in the Critically Ill in Continuous Renal Replacement Therapy: A Prospective Observational Study |
| title_fullStr | “CATCH” Study: Correct Antibiotic Therapy in Continuous Hemofiltration in the Critically Ill in Continuous Renal Replacement Therapy: A Prospective Observational Study |
| title_full_unstemmed | “CATCH” Study: Correct Antibiotic Therapy in Continuous Hemofiltration in the Critically Ill in Continuous Renal Replacement Therapy: A Prospective Observational Study |
| title_short | “CATCH” Study: Correct Antibiotic Therapy in Continuous Hemofiltration in the Critically Ill in Continuous Renal Replacement Therapy: A Prospective Observational Study |
| title_sort | catch study correct antibiotic therapy in continuous hemofiltration in the critically ill in continuous renal replacement therapy a prospective observational study |
| topic | pharmacodinamic parmacokinentics antibiotic acute kidney failure critically ill patients CVVH |
| url | https://www.mdpi.com/2079-6382/11/12/1811 |
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