High-dose colistin pharmacokinetics in critically ill patients receiving continuous renal replacement therapy
Authors' conclusion
In critically ill patients with CR infections undergoing CRRT, recommended CMS dosage resulted in colistin plasmatic levels above bacterial MIC90, but exceeding the safety Css, avg. limit.
Study context
- Population
- Critically ill patients with carbapenem-resistant (CR) bacterial infections (CR-Acinetobacter baumannii VAP) undergoing continuous renal replacement therapy (CRRT)
- Participants
- 20 patients
- Outcome
- Colistin PK/PD profile
- Follow-up
- After the seventh dose, serial sampling over 24 h
Methodological detailsprospective, consecutive patients, multicentre Intensive Care Units (ICUs) (3), Median SAPS II 41 [34.5-59.3] and SOFA 9 [6.7-11]
- Prospective
- Consecutive patients
- Multicentre ICUs (3)
- Median SAPS II 41 [34.5-59.3] and SOFA 9 [6.7-11]
Main finding
As reported in the abstract
24 h after the seventh dose
| Group | Value | Peak concentration | Trough concentration |
|---|---|---|---|
| Colistin | median 16.6 (IQR 14.8–20.6) mcg/mL | 16.6 | |
| Colistin | median 3.9 (IQR 3.3–4.4) mcg/mL | 3.9 |
Value
Colistinmedian 16.6 (IQR 14.8–20.6) mcg/mL
Colistinmedian 3.9 (IQR 3.3–4.4) mcg/mL
Peak concentration
Colistin16.6
Colistin— not stated in the abstract
Trough concentration
Colistin— not stated in the abstract
Colistin3.9
- Median AUC0 - 24 (mcg h/mL) [170.6-208.6]
- 193.9
- Median Css, avg (mcg/mL) [7.1-8.7]
- 8.07
- Probability of target attainment (fAUC0 - 24/MIC ≥ 12), MIC ≤ 2 mcg/mL
- 100%
- Probability of target attainment (fAUC0 - 24/MIC ≥ 12), MIC = 4 mcg/mL
- 85%
Observational data: associations, not effects.
Further findings
ICU mortality and renal recovery
- Died during ICU stay
- 15
- Recovered renal function
- 6
Safety
- Median Css, avg (mcg/mL) [7.1-8.7], exceeding the toxicity limit of Css, avg 3-4 mcg/mL
- 8.07
Original publication
High-dose colistin pharmacokinetics in critically ill patients receiving continuous renal replacement therapy. Ann Intensive Care. Published 28 September 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →