共 86 条
Pharmacokinetics and Dosing of Anti-infective Drugs in Patients on Extracorporeal Membrane Oxygenation: A Review of the Current Literature
被引:95
作者:

Sherwin, Jennifer
论文数: 0 引用数: 0
h-index: 0
机构:
Duke Univ, Dept Pediat, Durham, NC 27706 USA Duke Univ, Dept Pediat, Durham, NC 27706 USA

Heath, Travis
论文数: 0 引用数: 0
h-index: 0
机构:
Duke Univ, Dept Pediat, Durham, NC 27706 USA Duke Univ, Dept Pediat, Durham, NC 27706 USA

Watt, Kevin
论文数: 0 引用数: 0
h-index: 0
机构:
Duke Univ, Dept Pediat, Durham, NC 27706 USA Duke Univ, Dept Pediat, Durham, NC 27706 USA
机构:
[1] Duke Univ, Dept Pediat, Durham, NC 27706 USA
关键词:
antibiotics;
antifungals;
anti-infectives;
antivirals;
ECMO;
pharmacokinetics;
RESPIRATORY-DISTRESS-SYNDROME;
CRITICALLY-ILL PATIENTS;
POPULATION PHARMACOKINETICS;
CARDIOPULMONARY BYPASS;
PEDIATRIC-PATIENTS;
GENTAMICIN PHARMACOKINETICS;
VANCOMYCIN PHARMACOKINETICS;
MEROPENEM PHARMACOKINETICS;
OSELTAMIVIR CARBOXYLATE;
MATCHED COHORT;
D O I:
10.1016/j.clinthera.2016.07.169
中图分类号:
R9 [药学];
学科分类号:
1007 ;
摘要:
Purpose: Extracorporeal membrane oxygenation (ECMO) is a cardiopulmonary bypass device that is used to temporarily support the most critically ill of patients with respiratory and/or cardiac failure. Infection and its sequelae may be an indication for ECMO or infections may be acquired while on ECMO and are associated with a mortality >50%. Effective therapy requires optimal dosing. However, optimal dosing can be different in patients on ECMO because the ECMO circuit can alter drug pharmacokinetics. This review assessed the current literature for pharmacokinetic data and subsequent dosing recommendations for anti-infective drugs in patients on ECMO. Methods: We searched the PubMed and Embase databases (1965 to February 2016) and included case reports, case series, or studies that provided pharmacokinetic data for anti-infective drugs including antibiotics, antifungals, and antivirals being used to treat patients of all age groups on ECMO. Pharmacokinetic parameters and dosing recommendations based on these data are presented. Findings: The majority of data on this topic comes from neonatal studies of antibiotics from the 1980s and 1990s. These studies generally demonstrate a larger volume of distribution due to ECMO and therefore higher doses are needed initially. More adult data are now emerging, but with a predominance of case reports and case series without comparison with critically ill controls. The available pharmacokinetic analyses do suggest that volume of distribution. and clearance are unchanged in the adult population, and therefore dosing recommendations largely remain unchanged. There is a lack of data on children older than 1 year of age. The data support the importance of therapeutic drug monitoring when available in this population of patients. Implications: This review found reasonably robust dosing recommendations for some drugs and scant or no data for other important anti-infectives. In order to better determine optimal dosing for patients on ECMO, a systematic approach is needed. Approaches that combine ex vivo ECMO experiments, animal studies, specialized pharmacokinetic modeling, and human clinical trials are being developed. (C) 2016 Elsevier HS Journals, Inc. All rights reserved.
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页码:1976 / 1994
页数:19
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CHU Poitiers, Poitiers, France INSERM, ERI 23, EA 3809, F-86022 Poitiers, France

Robert, Rene
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CHU Poitiers, Poitiers, France INSERM, ERI 23, EA 3809, F-86022 Poitiers, France

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[80]
Fluconazole Population Pharmacokinetics and Dosing for Prevention and Treatment of Invasive Candidiasis in Children Supported with Extracorporeal Membrane Oxygenation
[J].
Watt, Kevin M.
;
Gonzalez, Daniel
;
Benjamin, Daniel K., Jr.
;
Brouwer, Kim L. R.
;
Wade, Kelly C.
;
Capparelli, Edmund
;
Barrett, Jeffrey
;
Cohen-Wolkowiez, Michael
.
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY,
2015, 59 (07)
:3935-3943

Watt, Kevin M.
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Duke Univ, Dept Pediat, Med Ctr, Durham, NC 27706 USA
Duke Univ, Duke Clin Res Inst, Med Ctr, Durham, NC 27706 USA
Univ N Carolina, Div Pharmacotherapy & Expt Therapeut, UNC Eshelman Sch Pharm, Chapel Hill, NC USA Duke Univ, Dept Pediat, Med Ctr, Durham, NC 27706 USA

Gonzalez, Daniel
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Duke Univ, Duke Clin Res Inst, Med Ctr, Durham, NC 27706 USA
Univ N Carolina, Div Pharmacotherapy & Expt Therapeut, UNC Eshelman Sch Pharm, Chapel Hill, NC USA Duke Univ, Dept Pediat, Med Ctr, Durham, NC 27706 USA

Benjamin, Daniel K., Jr.
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Duke Univ, Dept Pediat, Med Ctr, Durham, NC 27706 USA
Duke Univ, Duke Clin Res Inst, Med Ctr, Durham, NC 27706 USA Duke Univ, Dept Pediat, Med Ctr, Durham, NC 27706 USA

Brouwer, Kim L. R.
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Univ N Carolina, Div Pharmacotherapy & Expt Therapeut, UNC Eshelman Sch Pharm, Chapel Hill, NC USA Duke Univ, Dept Pediat, Med Ctr, Durham, NC 27706 USA

Wade, Kelly C.
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Childrens Hosp Philadelphia, Dept Pediat, Philadelphia, PA 19104 USA Duke Univ, Dept Pediat, Med Ctr, Durham, NC 27706 USA

Capparelli, Edmund
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Univ Calif San Diego, Dept Pediat, La Jolla, CA 92093 USA Duke Univ, Dept Pediat, Med Ctr, Durham, NC 27706 USA

Barrett, Jeffrey
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Childrens Hosp Philadelphia, Div Clin Pharmacol & Therapeut, Philadelphia, PA 19104 USA Duke Univ, Dept Pediat, Med Ctr, Durham, NC 27706 USA

Cohen-Wolkowiez, Michael
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Duke Univ, Dept Pediat, Med Ctr, Durham, NC 27706 USA
Duke Univ, Duke Clin Res Inst, Med Ctr, Durham, NC 27706 USA Duke Univ, Dept Pediat, Med Ctr, Durham, NC 27706 USA