甲氧苄啶
肾脏替代疗法
药代动力学
磺胺甲恶唑
肾功能
医学
加药
化学
血液透析
泌尿科
药理学
外科
内科学
抗生素
生物化学
作者
Jacob M Kesner,Joseph Michael Yardman‐Frank,Renée-Claude Mercier,Craig S. Wong,Scott Walker,Dean P. Argyres,A. Mary Vilay
出处
期刊:Blood Purification
[S. Karger AG]
日期:2014-01-01
卷期号:38 (3-4): 195-202
被引量:7
摘要
There is limited data regarding trimethoprim (TMP)/sulfamethoxazole (SMX) continuous renal replacement therapy (CRRT) dosing. We aimed to estimate TMP/SMX transmembrane clearance (CLtm) during continuous hemofiltration (CH) and continuous hemodialysis (CD) to guide dosing.Using an in vitro model, TMP/SMX sieving coefficients (SC) and saturation coefficients (SA) were determined with high-flux polyarylethersulfone and polyacrylonitrile-sodium methallyl sulfonate copolymer hemodiafilters at ultrafiltration/dialysate rates of 1, 2, 3, and 6 l/h. TMP/SMX CLtm was calculated using measured SC and SA. TMP/SMX CRRT doses were modeled using CLtm and published TMP/SMX pharmacokinetic parameters.TMP SC/SA during CH/CD were significantly higher than SMX SC/SA. During modeling, TMP 10 mg/kg/day and its corresponding SMX dose, 50 mg/kg/day, resulted in steady state TMP/SMX peak concentrations associated with efficacy against Pneumocystis jirovecii.CRRT resulted in greater TMP CLtm than SMX. TMP 10 mg/kg/day divided q12h may be an appropriate initial dose to consider in patients undergoing CRRT.
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