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Effects of Dialysis Membrane on Intradialytic Vancomycin Administration
Author(s) -
Scott Meri K.,
Macias William L.,
Kraus Michael A.,
Clark William R.,
Carfagna Mark A.,
Mueller Bruce A.
Publication year - 1997
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/j.1875-9114.1997.tb03707.x
Subject(s) - hemodialysis , vancomycin , medicine , dialysis , crossover study , cellulose triacetate , urology , surgery , cellulose , staphylococcus aureus , chemistry , placebo , alternative medicine , organic chemistry , pathology , biology , bacteria , genetics
Study Objective . To quantify the influence of hemodialyzers on vancomycin removal when the drug was infused during hemodialysis. Design . Prospective, controlled, crossover study with three arms. Setting . A university‐affiliated medical center. Patients . Eight subjects receiving outpatient hemodialysis. Interventions . The three treatment arms were vancomycin 1000 mg infused after dialysis was completed (control), and the same dosages infused during the last hour of hemodialysis with a cellulose triacetate (CT) and a cellulose acetate (CA) hemodialyzer. Measurements and Main Results . The areas under the curve from time zero to 44 hours (AUC0‐44 hrs) for the three study arms were significantly different (p<0.05), with the mean vancomycin AUC 0–44 hrs being significantly lower when administered during CT and CA dialysis (73.7% and 87.2% of control; p<0.05 vs control). The mean vancomycin peak concentration achieved during CT dialysis was significantly lower than for the CA and control arms (20.5, 23.9, 27.0 mg/L, respectively). Forty‐four‐hour postinfusion concentrations were similarly lower. Conclusion . Clinicians should recognize that the composition of the hemodialyzer significantly influences vancomycin serum concentrations when the drug is administered during hemodialysis.

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