Single-Dose Pharmacokinetics of Meropenem during Continuous Venovenous Hemofiltration

The pharmacokinetic properties of meropenem were investigated in nine critically ill patients treated by continuous venovenous hemofiltration (CVVH). All patients received one dose of 1 g of meropenem intravenously. High-flux polysulfone membranes were used as dialyzers. Meropenem levels were measured in plasma and ultrafiltrate by high-performance liquid chromatography. The total body clearance and elimination half-life were 143.7 ± 18.6 ml/min and 2.46 ± 0.41 h, respectively. The post- to prehemofiltration ratio of meropenem was 0.24 ± 0.06. Peak plasma drug concentrations measured 60 min postinfusion were 28.1 ± 2.7 μg/ml, and trough levels after 6 h of CVVH were 6.6 ± 1.5 μg/ml. The calculated total daily meropenem requirement in these patients with acute renal failure and undergoing CVVH was 2,482 ± 321 mg. Based on these data, we conclude that patients with severe infections who are undergoing CVVH can be treated effectively with 1 g of meropenem every 8 h.

本研究针对9例行连续性静脉-静脉血液滤过（continuous venovenous hemofiltration，CVVH）治疗的重症患者，对美罗培南（meropenem）的药代动力学特性展开探究。所有患者均单次静脉输注1g美罗培南，研究采用高通量聚砜膜作为透析器。采用高效液相色谱法（high-performance liquid chromatography）测定血浆与超滤液中的美罗培南浓度。患者的总体清除率与消除半衰期分别为143.7±18.6 ml/min及2.46±0.41 h，美罗培南的血液滤过前后浓度比值为0.24±0.06。输注后60分钟测得的血浆药物峰浓度为28.1±2.7 μg/ml，而CVVH治疗6小时后的谷浓度为6.6±1.5 μg/ml。经计算，此类合并急性肾衰竭且接受CVVH治疗的患者每日美罗培南总需求量为2482±321 mg。基于上述研究数据，本研究得出结论：合并重症感染且接受CVVH治疗的患者，可采用每8小时输注1g美罗培南的方案实现有效治疗。