Pharmacokinetics and pharmacodynamics of sequential intravenous and subcutaneous teicoplanin in critically ill patients without vasopressors
| Autor: | Agnès Barbot, Serge Bouquet, Bertrand Debaene, F. Rayeh, Nicolas Venisse, Olivier Mimoz |
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| Rok vydání: | 2002 |
| Předmět: |
Adult
Male Adolescent Metabolic Clearance Rate medicine.medical_treatment Critical Illness Injections Subcutaneous Critical Care and Intensive Care Medicine Loading dose Route of administration Pharmacokinetics Albumins medicine Humans Vasoconstrictor Agents Infusions Parenteral Prospective Studies Infusions Intravenous Antibacterial agent Aged Cross Infection Cross-Over Studies Teicoplanin business.industry Middle Aged Crossover study Anti-Bacterial Agents Treatment Outcome Intravenous therapy Anesthesia Pharmacodynamics Area Under Curve Female business medicine.drug |
| Zdroj: | Intensive care medicine. 29(9) |
| ISSN: | 0342-4642 |
| Popis: | To compare the pharmacokinetic parameters of sequential intravenous and subcutaneous teicoplanin in the plasma of surgical intensive care unit patients.Prospective, randomized, crossover study in the surgical ICU of a university hospital.Twelve patients with a suspected nosocomial infection, a serum albumin level higher than 10 g/l, body mass index less than 28 kg/m(2), and estimated creatinine clearance higher than 70 ml/min.Teicoplanin was first administered intravenously as a loading dose of 6 mg/kg per 12 h for 48 h and then continued at a daily dose of 6 mg/kg. On the fourth day patients were randomized in two groups according to the order of the pharmacokinetic studies.Serial plasma samples were obtained to measure teicoplanin levels. Compared with a 30-min intravenous infusion the peak concentration of teicoplanin after a 30-min subcutaneous administration occurred later (median 7 h, range 5-18) and was lower (16 micro g/ml, 9-31; vs. 73, 53-106). Despite large and unpredictable interindividual differences no significant differences between subcutaneous and intravenous administration were observed in: trough antibiotic concentrations (10 micro g/ml, 6-24; vs. 9, 5-30), the area under the teicoplanin plasma concentration vs. time curves from 0 to 24 h (AUC(0-24h); 309 micro g/ml per minute, 180-640; vs. 369, 171-955), the proportion of the dosing interval during which the plasma teicoplanin concentration exceeded 10 micro g/ml (96%, 0-100%; vs. 79%, 13-100%), and the ratio of AUC(0-24h) to 10 (77, 45-160; vs. 92, 43-239).In critically ill patients without vasopressors a switch to the subcutaneous teicoplanin after an initial intravenous therapy seems to give comparable pharmacodynamic indexes of therapeutic success. |
| Databáze: | OpenAIRE |
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