[Behaviour of vancomycin with the new techniques in haemodialysis]. / Comportamiento de la vancomicina con tas nuevas técnicas de diálisis.
Nefrologia
; 25(5): 527-34, 2005.
Article
en Es
| MEDLINE
| ID: mdl-16392303
ABSTRACT
UNLABELLED When using high convection dialysis techniques it arouses the necessity of considering the suitability of the regular protocols when administrating drugs, such as vancomycin. OBJECTIVES:
To confirm if the usual guideline of vancomycin is efficient in patients undergoing treatments with acetate free biofiltration (AFB) and haemodiafiltration on-line (on-line). To propose an alternative guideline of administration. MATERIAL ANDMETHODS:
13 patients treated with AFB or On-line. 10 of them used filters of polysulfone and 3 of them of AN69. First part 6 patients were administered 1 g iv during the last hour of dialysis. Second part 7 patients were given a loading dose of 30 mg/kg iv with a reinforcement of 500 mg post-dialysis. The blood levels of the antibiotic were monitorized during the week following the administration.OUTCOMES:
During the first phase it was noticed a decrease of 41% in the serum level of vancomycin during dialysis, conditioning subtherapeutic levels in the 83% of the patients until the end of the study. As for the second phase, therapeutic non-toxic levels were maintained during the whole study. The existence of a post-dialysis rebound of the 21 % was confirmed. A bigger clearance of vancomycin was obtained with the On-line technique rather than with AFB (176 vs 135 ml/min). We find a strong correlation between the decrease of the antibiotic and the volume ultrafiltrated with the On-line technique.CONCLUSIONS:
The usual guideline of vancomycin may not be enough with the new convective dialysis techniques. A guideline based on a loading dose of 30 mg/kg and a reinforcement of 500 mg at the end of each dialysis could be adequate. The antibiotic clearance with the On-line technique is probably made by convective transport.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Vancomicina
/
Hemodiafiltración
/
Antibacterianos
Tipo de estudio:
Guideline
Límite:
Humans
Idioma:
Es
Revista:
Nefrologia
Año:
2005
Tipo del documento:
Article