Pharmacokinetics of Sulfamethoxazole and Trimethoprim During Venovenous Extracorporeal Membrane Oxygenation: A Case Report.
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Authors
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Dhanani, Jayesh A1, 2, 3
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Lipman, Jeffrey1, 3
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Pincus, Jason3, 4
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Townsend, Shane3, 4
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Livermore, Amelia3
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Wallis, Steven C1
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Pandey, Saurabh5
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Abdul-Aziz, Mohd H1
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Roberts, Jason A1, 3, 6, 7, 8
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1
Faculty of Medicine, University of Queensland Centre of Clinical Research, The University of Queensland, Brisbane, Queensland, Australia.
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(Australia)
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2
School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia.
,
(Australia)
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3
Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.
,
(Australia)
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4
School of Medicine, University of Queensland, Herston, Queensland, Australia.
,
(Australia)
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5
University Of Queensland Centre for Clinical Research, University of Queensland, Herston, Queensland, Australia.
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(Australia)
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6
Department of Pharmacy, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
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(Australia)
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7
Centre for Translational Anti-infective Pharmacodynamics, School of Pharmacy, The University of Queensland, Brisbane, Queensland, Australia.
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(Australia)
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8
Division of Anaesthesiology Critical Care Emergency and Pain Medicine, Nîmes University Hospital, University of Montpellier, Nîmes, France.
,
(France)
- Type
- Published Article
- Journal
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Pharmacotherapy
- Publication Date
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Jul 01, 2020
- Volume
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40
- Issue
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7
- Pages
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713–717
- Identifiers
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DOI: 10.1002/phar.2413
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PMID: 32378219
- Source
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Medline
- Keywords
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- Language
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English
- License
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Unknown
Abstract
Extracorporeal membrane oxygenation (ECMO) therapy could affect drug concentrations via adsorption onto the oxygenator and/or associated circuit. We describe a case of a 33-year-old man with severe respiratory failure due to Pneumocystis jirovecii infection on a background of recently diagnosed human immunodeficiency virus infection. He required venovenous ECMO therapy for refractory respiratory failure. Intravenous sulfamethoxazole-trimethoprim (100 and 20 mg/kg/day) was administered in a dosing regimen every 6 hours. Pre-oxygenator, post-oxygenator, and arterial blood samples were collected after antibiotic administration and were analyzed for total sulfamethoxazole and trimethoprim concentrations. The peak sulfamethoxazole and trimethoprim concentrations were 122 mg/L and 5.3 mg/L, respectively. The volume of distribution for sulfamethoxazole was 0.37 and 2.30 L/kg for trimethoprim. The clearance for sulfamethoxazole was 0.35 ml/minute/kg and for trimethoprim was 1.64 ml/minute/kg. The pharmacokinetics of sulfamethoxazole and trimethoprim appear not to be affected by ECMO therapy, and dosing adjustment may not be required. © 2020 Pharmacotherapy Publications, Inc.
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
This record was last updated on 01/04/2021 and may not reflect the most current and accurate biomedical/scientific data available from NLM.
The corresponding record at NLM can be accessed at
https://www.ncbi.nlm.nih.gov/pubmed/32378219
