J Porter Hunt, Autumn M McKnite, Danielle J Green, Aviva J Whelan, Carina E Imburgia, Kevin M Watt
Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 2023 DecCeftazidime and clindamycin are commonly prescribed to critically ill patients who require extracorporeal life support such as ECMO and CRRT. The effect of ECMO and CRRT on the disposition of ceftazidime and clindamycin is currently unknown. Ceftazidime and clindamycin extraction were studied with ex vivo ECMO and CRRT circuits primed with human blood. The percent recovery of these drugs over time was calculated to determine the degree of interaction between these drugs and circuit components. Neither ceftazidime nor clindamycin exhibited measurable interactions with the ECMO circuit. In contrast, CRRT cleared 100% of ceftazidime from the experimental circuit within the first 2 h. Clearance of clindamycin from the CRRT circuit was slower, with about 20% removed after 6 h. Clindamycin and ceftazidime dosing adjustments are likely required in patients who are supported with CRRT, and future studies to quantify these adjustments should consider the pathophysiology of the patient in combination with the clearance due to CRRT. Dosing adjustments to account for adsorption to ECMO circuit components are likely unnecessary and should focus instead on the pathophysiology of the patient and changes in volume of distribution. These results will help improve the safety and efficacy of ceftazidime and clindamycin in patients requiring ECMO and CRRT. Copyright © 2023 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved.
J Porter Hunt, Autumn M McKnite, Danielle J Green, Aviva J Whelan, Carina E Imburgia, Kevin M Watt. Interaction of ceftazidime and clindamycin with extracorporeal life support. Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy. 2023 Dec;29(12):1119-1125
PMID: 37572979
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