Influence of continuous renal replacement therapy on the plasma concentration of tigecycline in patients with septic shock: A prospective observational study
Objective: The influence of continuous renal replacement therapy (CRRT) on the steady-state plasma concentration of high-dose tigecycline was investigated in septic shock patients to provide references for drug dosing.Methods: In this prospective observational study, 17 septic shock patients present...
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2023.1118788/full |
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| author | Fang Huang Wen-Xiang Cao Yu-Ying Yan Tian-Tian Mao Xian-Wen Wang Dan Huang Yu-Shuang Qiu Wen-Jie Lu Dong-Jie Li Yu-Gang Zhuang |
| author_facet | Fang Huang Wen-Xiang Cao Yu-Ying Yan Tian-Tian Mao Xian-Wen Wang Dan Huang Yu-Shuang Qiu Wen-Jie Lu Dong-Jie Li Yu-Gang Zhuang |
| author_sort | Fang Huang |
| collection | DOAJ |
| description | Objective: The influence of continuous renal replacement therapy (CRRT) on the steady-state plasma concentration of high-dose tigecycline was investigated in septic shock patients to provide references for drug dosing.Methods: In this prospective observational study, 17 septic shock patients presenting with severe infections needing a broad-spectrum antibiotic therapy with high-dose tigecycline (100 mg per 12 h) in the intensive care unit were included and divided into CRRT group (n = 6) or non-CRRT group (n = 11). The blood samples were collected and plasma drug concentration was determined by SHIMADZU LC-20A and SHIMADZU LCMS 8040. The steady-state plasma concentration was compared between groups using unpaired t-test. Furthermore, between-groups comparisons adjusted for baseline value was also done using multivariate linear regression model.Results: Peak concentration (Cmax) of tigecycline was increased in CRRT group compared to non-CRRT group, but there were no statistical differences (505.11 ± 143.84 vs. 406.29 ± 108.00 ng/mL, p-value: 0.129). Trough concentration (Cmin) of tigecycline was significantly higher in CRRT group than in non-CRRT group, with statistical differences (287.92 ± 41.91 vs. 174.79 ± 33.15 ng/mL, p-value: 0.000, adjusted p-value: 0.000). In safety, Cmin was reported to be a useful predictor of hepatotoxicity with a cut-off of 474.8 ng/mL. In our studies, Cmin of all patients in CRRT group was lower than 474.8 ng/mL.Conclusion: The plasma concentration of tigecycline was increased in septic shock patients with CRRT treatment and only Cmin shown statistical differences. No dose adjustment seems needed in the view of hepatotoxicity.Clinical Trial Registration:https://www.chictr.org.cn/, identifier ChiCTR2000037475. |
| first_indexed | 2024-04-10T05:13:16Z |
| format | Article |
| id | doaj.art-f3acc2b70dd246dcaa86bf073bbcfedd |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-04-10T05:13:16Z |
| publishDate | 2023-03-01 |
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| series | Frontiers in Pharmacology |
| spelling | doaj.art-f3acc2b70dd246dcaa86bf073bbcfedd2023-03-09T06:22:02ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122023-03-011410.3389/fphar.2023.11187881118788Influence of continuous renal replacement therapy on the plasma concentration of tigecycline in patients with septic shock: A prospective observational studyFang Huang0Wen-Xiang Cao1Yu-Ying Yan2Tian-Tian Mao3Xian-Wen Wang4Dan Huang5Yu-Shuang Qiu6Wen-Jie Lu7Dong-Jie Li8Yu-Gang Zhuang9Department of Pharmacy, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Pharmacy, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, ChinaSchool of Pharmacy, Nanjing Medical University, Nanjing, ChinaDepartment of Emergency Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Emergency Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Emergency Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Pharmacy, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Pharmacy, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Pharmacy, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Emergency Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, ChinaObjective: The influence of continuous renal replacement therapy (CRRT) on the steady-state plasma concentration of high-dose tigecycline was investigated in septic shock patients to provide references for drug dosing.Methods: In this prospective observational study, 17 septic shock patients presenting with severe infections needing a broad-spectrum antibiotic therapy with high-dose tigecycline (100 mg per 12 h) in the intensive care unit were included and divided into CRRT group (n = 6) or non-CRRT group (n = 11). The blood samples were collected and plasma drug concentration was determined by SHIMADZU LC-20A and SHIMADZU LCMS 8040. The steady-state plasma concentration was compared between groups using unpaired t-test. Furthermore, between-groups comparisons adjusted for baseline value was also done using multivariate linear regression model.Results: Peak concentration (Cmax) of tigecycline was increased in CRRT group compared to non-CRRT group, but there were no statistical differences (505.11 ± 143.84 vs. 406.29 ± 108.00 ng/mL, p-value: 0.129). Trough concentration (Cmin) of tigecycline was significantly higher in CRRT group than in non-CRRT group, with statistical differences (287.92 ± 41.91 vs. 174.79 ± 33.15 ng/mL, p-value: 0.000, adjusted p-value: 0.000). In safety, Cmin was reported to be a useful predictor of hepatotoxicity with a cut-off of 474.8 ng/mL. In our studies, Cmin of all patients in CRRT group was lower than 474.8 ng/mL.Conclusion: The plasma concentration of tigecycline was increased in septic shock patients with CRRT treatment and only Cmin shown statistical differences. No dose adjustment seems needed in the view of hepatotoxicity.Clinical Trial Registration:https://www.chictr.org.cn/, identifier ChiCTR2000037475.https://www.frontiersin.org/articles/10.3389/fphar.2023.1118788/fullhigh-dose tigecyclinecontinuous renal replacement therapyseptic shockplasma concentrationdose adjustment |
| spellingShingle | Fang Huang Wen-Xiang Cao Yu-Ying Yan Tian-Tian Mao Xian-Wen Wang Dan Huang Yu-Shuang Qiu Wen-Jie Lu Dong-Jie Li Yu-Gang Zhuang Influence of continuous renal replacement therapy on the plasma concentration of tigecycline in patients with septic shock: A prospective observational study Frontiers in Pharmacology high-dose tigecycline continuous renal replacement therapy septic shock plasma concentration dose adjustment |
| title | Influence of continuous renal replacement therapy on the plasma concentration of tigecycline in patients with septic shock: A prospective observational study |
| title_full | Influence of continuous renal replacement therapy on the plasma concentration of tigecycline in patients with septic shock: A prospective observational study |
| title_fullStr | Influence of continuous renal replacement therapy on the plasma concentration of tigecycline in patients with septic shock: A prospective observational study |
| title_full_unstemmed | Influence of continuous renal replacement therapy on the plasma concentration of tigecycline in patients with septic shock: A prospective observational study |
| title_short | Influence of continuous renal replacement therapy on the plasma concentration of tigecycline in patients with septic shock: A prospective observational study |
| title_sort | influence of continuous renal replacement therapy on the plasma concentration of tigecycline in patients with septic shock a prospective observational study |
| topic | high-dose tigecycline continuous renal replacement therapy septic shock plasma concentration dose adjustment |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2023.1118788/full |
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