Adsorption of vancomycin, gentamycin, ciprofloxacin and tygecycline on the filters in continuous renal replacement thera
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ORIGINAL ARTICLE Artificial Kidney / Dialysis
Adsorption of vancomycin, gentamycin, ciprofloxacin and tygecycline on the filters in continuous renal replacement therapy circuits: in full blood in vitro study Dariusz Onichimowski1 · Krzysztof Nosek3 · Hubert Ziółkowski2 · Jerzy Jaroszewski2 · Aleksandra Pawlos3 · Mirosław Czuczwar4 Received: 3 May 2020 / Accepted: 22 September 2020 © The Author(s) 2020
Abstract The aim of this study was to assess the in vitro adsorption of antibiotics: vancomycin, gentamicin, ciprofloxacin and tigecycline on both polyethyleneimine-treated polyacrylonitrile membrane of AN69ST filter and polysulfone membrane of AV1000 filter using porcine blood as a model close to in vivo conditions. The porcine blood with antibiotic dissolved in it was pumped into hemofiltration circuit (with AN69ST or AV1000 filter), ultrafiltration fluid was continuously returned to the reservoir containing blood with antibiotic. Blood samples to determine antibiotic concentrations were taken at minutes 0, 5, 15, 30, 45, 60, 90 and 120 from the pre- blood pump of the hemofiltration circuit. To assess possible spontaneous degradation of the drug in the solution there was an additional reservoir prepared for each antibiotic, containing blood with the drug, which was not connected to the circuit. In the case of vancomycin, ciprofloxacine and tigecycline, a statistically significant decrease in the drug concentration in the hemofiltration circuit in comparison to initial value as well as to the concentrations in the control blood was observed, both for polyacrylonitrile and plolysulfone membrane. In the case of gentamicin, significant adsorption was noted only on polyacrylonitrile membrane. Our studies demonstrated that in full blood adsorption of antibiotics may be big enough to be of clinical significance. In particular in the case of polyacrylonitrile membrane. Keywords Vancomycin · Gentamycin · Ciprofloxacin · Tigecycline · Adsorption
Introduction * Dariusz Onichimowski [email protected] * Krzysztof Nosek [email protected] 1
Department of Anaesthesiology and Intensive Therapy, Faculty of Medicine, University of Warmia and Mazury, Al. Warszawska 30, 11‑082 Olsztyn, Poland
2
Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, University of Warmia and Mazury, Oczapowskiego 13, 10‑719 Olsztyn, Poland
3
Department of Pharmacology and Toxicology, Faculty of Medicine, University of Warmia and Mazury, Al. Warszawska 30, 10‑082 Olsztyn, Poland
4
2nd Department of Anaesthesiology and Intensive Therapy, Medical Univeristy of Lublin, Staszica 16, 20‑081 Lublin, Poland
Optimum antibiotic dosing in the treatment of severe infections and septic shock is of key importance for achieving a therapeutic success; it remains, however, a major challenge in intensive therapy units. This is due to the complexity and variability of antibiotic pharmacokinetics in critically ill patients as well as increasing antimicrobial resistance, but also due to the use of medical technologies which have an eff
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