Dialyzability of Faropenem in Infected Patients on Chronic Hemodialysis

The aim of this study was to evaluate the profile of dialyzability of an oral penem antibiotic, faropenem (FRPM), in hemodialysis (HD) patients with infections. Eight patients took one tablet of FRPM (200 mg) every 12 h during an inter-dialysis period, and another tablet at 1-5 h before the beginning of the HD session. Blood samples were obtained during the HD session (3-4 h). Plasma FRPM concentrations in the arterial side were 4.8 ± 2.5 and 2.8 ± 1.0 µg/mL before and at the end of HD session, respectively, which are above the 50% minimal inhibitory concentrations of FRPM against the major pathogen (0.015-2 µg/mL). Dialyzer clearance and elimination fraction of FRPM were 14.9 ± 6.8 mL/min per m2 and 20.4 ± 9.9%, respectively. About 2% of FRPM was removed from the body during a single HD session. The infection-related symptoms, the white blood cell count and the level of C-reactive protein were improved by FRPM without any adverse effects. These data suggest that the dialyzability of FRPM is relatively low, and the amount of the drug removed by a single HD session is small. FRPM 200 mg twice daily might provide an effective and safe dosage regimen without additional dosing at the end of the HD session.