High-dose colistin pharmacokinetics in critically ill patients receiving continuous renal replacement therapy.
Colistimethate
Colistin
Critical care
Infection
Sepsis
Journal
Annals of intensive care
ISSN: 2110-5820
Titre abrégé: Ann Intensive Care
Pays: Germany
ID NLM: 101562873
Informations de publication
Date de publication:
28 Sep 2024
28 Sep 2024
Historique:
received:
11
03
2024
accepted:
18
09
2024
medline:
28
9
2024
pubmed:
28
9
2024
entrez:
28
9
2024
Statut:
epublish
Résumé
Colistin, administered as intravenous colistimethate (CMS), is still used in the critical care setting and current guidelines recommend high dosage CMS in patients undergoing continuous renal replacement therapy (CRRT). Due to the paucity of real-life data, we aimed to describe colistin pharmacokinetic/pharmacodynamic (PK/PD) profile in a cohort of critically ill patients with infections due to carbapenem-resistant (CR) bacteria undergoing CRRT. All consecutive patients admitted to three Intensive Care Units (ICUs) of a large metropolitan University Hospital, treated with colistin for at least 48 h at the dosage of 6.75 MUI q12, after 9 MIU loading dose, and undergoing CRRT were included. After the seventh dose, patients underwent blood serial sampling during a time frame of 24 h. We included 20 patients, who had CR-Acinetobacter baumannii ventilator-associated pneumonia and were characterized by a median SAPS II and SOFA score of 41 [34.5-59.3] and 9 [6.7-11], respectively. Fifteen patients died during ICU stay and six recovered renal function. Median peak and trough colistin concentrations were 16.6 mcg/mL [14.8-20.6] and 3.9 mcg/mL [3.3-4.4], respectively. Median area under the time-concentration curve (AUC In critically ill patients with CR infections undergoing CRRT, recommended CMS dosage resulted in colistin plasmatic levels above bacterial MIC This trial was registered in ClinicalTrials.gov on 23/07/2021 with the ID NCT04995133 (https//clinicaltrials.gov/study/NCT04995133).
Sections du résumé
BACKGROUND
BACKGROUND
Colistin, administered as intravenous colistimethate (CMS), is still used in the critical care setting and current guidelines recommend high dosage CMS in patients undergoing continuous renal replacement therapy (CRRT). Due to the paucity of real-life data, we aimed to describe colistin pharmacokinetic/pharmacodynamic (PK/PD) profile in a cohort of critically ill patients with infections due to carbapenem-resistant (CR) bacteria undergoing CRRT.
RESULTS
RESULTS
All consecutive patients admitted to three Intensive Care Units (ICUs) of a large metropolitan University Hospital, treated with colistin for at least 48 h at the dosage of 6.75 MUI q12, after 9 MIU loading dose, and undergoing CRRT were included. After the seventh dose, patients underwent blood serial sampling during a time frame of 24 h. We included 20 patients, who had CR-Acinetobacter baumannii ventilator-associated pneumonia and were characterized by a median SAPS II and SOFA score of 41 [34.5-59.3] and 9 [6.7-11], respectively. Fifteen patients died during ICU stay and six recovered renal function. Median peak and trough colistin concentrations were 16.6 mcg/mL [14.8-20.6] and 3.9 mcg/mL [3.3-4.4], respectively. Median area under the time-concentration curve (AUC
CONCLUSIONS
CONCLUSIONS
In critically ill patients with CR infections undergoing CRRT, recommended CMS dosage resulted in colistin plasmatic levels above bacterial MIC
TRIAL REGISTRATION
BACKGROUND
This trial was registered in ClinicalTrials.gov on 23/07/2021 with the ID NCT04995133 (https//clinicaltrials.gov/study/NCT04995133).
Identifiants
pubmed: 39340688
doi: 10.1186/s13613-024-01384-1
pii: 10.1186/s13613-024-01384-1
doi:
Banques de données
ClinicalTrials.gov
['NCT04995133']
Types de publication
Journal Article
Langues
eng
Pagination
152Informations de copyright
© 2024. The Author(s).
Références
Vincent JL, Sakr Y, Singer M, Martin-Loeches I, Machado FR, Marshall JC, et al. Prevalence and outcomes of infection among patients in Intensive Care Units in 2017. JAMA. 2020;323(15):1478–87.
doi: 10.1001/jama.2020.2717
pubmed: 32207816
pmcid: 7093816
Tabah A, Buetti N, Staiquly Q, Ruckly S, Akova M, Aslan AT, et al. Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study. Intensive Care Med. 2023;49(2):178–90.
doi: 10.1007/s00134-022-06944-2
pubmed: 36764959
pmcid: 9916499
Vincent JL, Rello J, Marshall J, Silva E, Anzueto A, Martin CD, et al. International study of the prevalence and outcomes of infection in intensive care units. JAMA. 2009;302(21):2323–9.
doi: 10.1001/jama.2009.1754
pubmed: 19952319
Vincent JL, Bihari DJ, Suter PM, Bruining HA, White J, Nicolas-Chanoin MH, et al. The prevalence of nosocomial infection in intensive care units in Europe. Results of the European prevalence of infection in Intensive Care (EPIC) study. EPIC International Advisory Committee. JAMA. 1995;274(8):639–44.
doi: 10.1001/jama.1995.03530080055041
pubmed: 7637145
Lombardi G, Tanzarella ES, Cutuli SL, De Pascale G. Treatment of severe infections caused by ESBL or carbapenemases-producing Enterobacteriaceae. Med Intensiva (Engl Ed). 2023;47(1):34–44.
doi: 10.1016/j.medin.2022.09.001
pubmed: 36202744
Rando E, Cutuli SL, Sangiorgi F, Tanzarella ES, Giovannenze F, De Angelis G, et al. Cefiderocol-containing regimens for the treatment of carbapenem-resistant A. Baumannii ventilator-associated pneumonia: a propensity-weighted cohort study. JAC Antimicrob Resist. 2023;5(4):dlad085.
doi: 10.1093/jacamr/dlad085
pubmed: 37484029
pmcid: 10359102
Lim LM, Ly N, Anderson D, Yang JC, Macander L, Jarkowski A 3, et al. Resurgence of colistin: a review of resistance, toxicity, pharmacodynamics, and dosing. Pharmacotherapy. 2010;30(12):1279–91.
doi: 10.1592/phco.30.12.1279
pubmed: 21114395
pmcid: 4410713
De Pascale GA. How to use Colistin in the ICU. Clin Pulm Med. 2015;22(3):141–7.
doi: 10.1097/CPM.0000000000000098
Pogue JM, Lee J, Marchaim D, Yee V, Zhao JJ, Chopra T, et al. Incidence of and risk factors for colistin-associated nephrotoxicity in a large academic health system. Clin Infect Dis. 2011;53(9):879–84.
doi: 10.1093/cid/cir611
pubmed: 21900484
Sorli L, Luque S, Grau S, Berenguer N, Segura C, Montero MM, et al. Trough colistin plasma level is an independent risk factor for nephrotoxicity: a prospective observational cohort study. BMC Infect Dis. 2013;13:380.
doi: 10.1186/1471-2334-13-380
pubmed: 23957376
pmcid: 3765824
Horcajada JP, Sorli L, Luque S, Benito N, Segura C, Campillo N, et al. Validation of a colistin plasma concentration breakpoint as a predictor of nephrotoxicity in patients treated with colistin methanesulfonate. Int J Antimicrob Agents. 2016;48(6):725–7.
doi: 10.1016/j.ijantimicag.2016.08.020
pubmed: 28128096
Forrest A, Garonzik SM, Thamlikitkul V, Giamarellos-Bourboulis EJ, Paterson DL, Li J et al. Pharmacokinetic/Toxicodynamic Analysis of Colistin-Associated Acute Kidney Injury in critically ill patients. Antimicrob Agents Chemother. 2017;61(11).
Tsuji BT, Pogue JM, Zavascki AP, Paul M, Daikos GL, Forrest A, et al. International Consensus guidelines for the optimal use of the polymyxins: endorsed by the American College of Clinical Pharmacy (ACCP), European Society of Clinical Microbiology and Infectious diseases (ESCMID), Infectious Diseases Society of America (IDSA), International Society for anti-infective pharmacology (ISAP), society of critical Care Medicine (SCCM), and Society of Infectious diseases pharmacists (SIDP). Pharmacotherapy. 2019;39(1):10–39.
doi: 10.1002/phar.2209
pubmed: 30710469
pmcid: 7437259
Garonzik SM, Li J, Thamlikitkul V, Paterson DL, Shoham S, Jacob J, et al. Population pharmacokinetics of colistin methanesulfonate and formed colistin in critically ill patients from a multicenter study provide dosing suggestions for various categories of patients. Antimicrob Agents Chemother. 2011;55(7):3284–94.
doi: 10.1128/AAC.01733-10
pubmed: 21555763
pmcid: 3122440
Nation RL, Garonzik SM, Thamlikitkul V, Giamarellos-Bourboulis EJ, Forrest A, Paterson DL, et al. Dosing guidance for intravenous colistin in critically-ill patients. Clin Infect Dis. 2017;64(5):565–71.
pubmed: 28011614
Cutuli SL, Cascarano L, Lazzaro P, Tanzarella ES, Pintaudi G, Grieco DL et al. Antimicrobial exposure in critically ill patients with Sepsis-Associated Multi-organ Dysfunction requiring extracorporeal organ support: a narrative review. Microorganisms. 2023;11(2).
von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP, et al. The strengthening the reporting of Observational studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):344–9.
doi: 10.1016/j.jclinepi.2007.11.008
Group KAW. KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl. 2012;17:1–138.
Evans L, Rhodes A, Alhazzani W, Antonelli M, Coopersmith CM, French C, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Intensive Care Med. 2021;47(11):1181–247.
doi: 10.1007/s00134-021-06506-y
pubmed: 34599691
pmcid: 8486643
Force ADT, Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E, et al. Acute respiratory distress syndrome: the Berlin definition. JAMA. 2012;307(23):2526–33.
Chawla LS, Bellomo R, Bihorac A, Goldstein SL, Siew ED, Bagshaw SM, et al. Acute kidney disease and renal recovery: consensus report of the Acute Disease Quality Initiative (ADQI) 16 workgroup. Nat Rev Nephrol. 2017;13(4):241–57.
doi: 10.1038/nrneph.2017.2
pubmed: 28239173
Roberts JA, Abdul-Aziz MH, Lipman J, Mouton JW, Vinks AA, Felton TW, et al. Individualised antibiotic dosing for patients who are critically ill: challenges and potential solutions. Lancet Infect Dis. 2014;14(6):498–509.
doi: 10.1016/S1473-3099(14)70036-2
pubmed: 24768475
pmcid: 4181663
Gobin P, Lemaitre F, Marchand S, Couet W, Olivier JC. Assay of colistin and colistin methanesulfonate in plasma and urine by liquid chromatography-tandem mass spectrometry. Antimicrob Agents Chemother. 2010;54(5):1941–8.
doi: 10.1128/AAC.01367-09
pubmed: 20176909
pmcid: 2863609
De Pascale G, Pintaudi G, Lisi L, De Maio F, Cutuli SL, Tanzarella ES et al. Use of High-Dose Nebulized Colistimethate in patients with colistin-only susceptible Acinetobacter baumannii VAP: clinical, pharmacokinetic and Microbiome features. Antibiot (Basel). 2023;12(1).
Gregoire N, Aranzana-Climent V, Magreault S, Marchand S, Couet W. Clinical pharmacokinetics and pharmacodynamics of Colistin. Clin Pharmacokinet. 2017;56(12):1441–60.
doi: 10.1007/s40262-017-0561-1
pubmed: 28550595
Nation RL, Li J, Cars O, Couet W, Dudley MN, Kaye KS, et al. Framework for optimisation of the clinical use of colistin and polymyxin B: the Prato polymyxin consensus. Lancet Infect Dis. 2015;15(2):225–34.
doi: 10.1016/S1473-3099(14)70850-3
pubmed: 25459221
Honore PM, Jacobs R, Lochy S, De Waele E, Van Gorp V, De Regt J, et al. Acute respiratory muscle weakness and apnea in a critically ill patient induced by colistin neurotoxicity: key potential role of hemoadsorption elimination during continuous venovenous hemofiltration. Int J Nephrol Renovasc Dis. 2013;6:107–11.
doi: 10.2147/IJNRD.S42791
pubmed: 23776390
pmcid: 3681400
Li J, Rayner CR, Nation RL, Deans R, Boots R, Widdecombe N, et al. Pharmacokinetics of colistin methanesulfonate and colistin in a critically ill patient receiving continuous venovenous hemodiafiltration. Antimicrob Agents Chemother. 2005;49(11):4814–5.
doi: 10.1128/AAC.49.11.4814-4815.2005
pubmed: 16251342
pmcid: 1280168
Karvanen M, Plachouras D, Friberg LE, Paramythiotou E, Papadomichelakis E, Karaiskos I, et al. Colistin methanesulfonate and colistin pharmacokinetics in critically ill patients receiving continuous venovenous hemodiafiltration. Antimicrob Agents Chemother. 2013;57(1):668–71.
doi: 10.1128/AAC.00985-12
pubmed: 23147733
pmcid: 3535942
Markou N, Fousteri M, Markantonis SL, Zidianakis B, Hroni D, Boutzouka E, et al. Colistin pharmacokinetics in intensive care unit patients on continuous venovenous haemodiafiltration: an observational study. J Antimicrob Chemother. 2012;67(10):2459–62.
doi: 10.1093/jac/dks257
pubmed: 22790220
Karaiskos I, Friberg LE, Galani L, Ioannidis K, Katsouda E, Athanassa Z, et al. Challenge for higher colistin dosage in critically ill patients receiving continuous venovenous haemodiafiltration. Int J Antimicrob Agents. 2016;48(3):337–41.
doi: 10.1016/j.ijantimicag.2016.06.008
pubmed: 27474468
Menna P, Salvatorelli E, Mattei A, Cappiello D, Minotti G, Carassiti M. Modified Colistin Regimen for critically ill patients with Acute Renal impairment and continuous renal replacement therapy. Chemotherapy. 2018;63(1):35–8.
doi: 10.1159/000484974
pubmed: 29334366
Mariano F, Leporati M, Carignano P, Stella M, Vincenti M, Biancone L. Efficient removal of colistin A and B in critically ill patients undergoing CVVHDF and sorbent technologies. J Nephrol. 2015;28(5):623–31.
doi: 10.1007/s40620-014-0143-3
pubmed: 25249467
Akers KS, Rowan MP, Niece KL, Stewart IJ, Mende K, Cota JM, et al. Colistin pharmacokinetics in burn patients during continuous venovenous hemofiltration. Antimicrob Agents Chemother. 2015;59(1):46–52.
doi: 10.1128/AAC.03783-14
pubmed: 25313211
Leuppi-Taegtmeyer AB, Decosterd L, Osthoff M, Mueller NJ, Buclin T, Corti N. Multicenter Population Pharmacokinetic Study of Colistimethate Sodium and Colistin dosed as in normal renal function in patients on continuous renal replacement therapy. Antimicrob Agents Chemother. 2019;63(2).
De Pascale G, Sandroni C, Antonelli M. Colistin use in critically ill patients: in search of the optimal dosing. Chest. 2011;139(1):234. author reply – 5.
doi: 10.1378/chest.10-2031
pubmed: 21208893
Gkoufa A, Sou T, Karaiskos I, Routsi C, Lin YW, Psichogiou M, et al. Pulmonary and systemic pharmacokinetics of colistin methanesulfonate (CMS) and formed colistin following nebulisation of CMS among patients with ventilator-associated pneumonia. Int J Antimicrob Agents. 2022;59(6):106588.
doi: 10.1016/j.ijantimicag.2022.106588
pubmed: 35405269
Boisson M, Jacobs M, Gregoire N, Gobin P, Marchand S, Couet W, et al. Comparison of intrapulmonary and systemic pharmacokinetics of colistin methanesulfonate (CMS) and colistin after aerosol delivery and intravenous administration of CMS in critically ill patients. Antimicrob Agents Chemother. 2014;58(12):7331–9.
doi: 10.1128/AAC.03510-14
pubmed: 25267660
pmcid: 4249558
Madia F, Merico B, Primiano G, Cutuli SL, De Pascale G, Servidei S. Acute myopathic quadriplegia in patients with COVID-19 in the intensive care unit. Neurology. 2020;95(11):492–4.
doi: 10.1212/WNL.0000000000010280
pubmed: 32601119
Luigetti M, Iorio R, Bentivoglio AR, Tricoli L, Riso V, Marotta J, et al. Assessment of neurological manifestations in hospitalized patients with COVID-19. Eur J Neurol. 2020;27(11):2322–8.
doi: 10.1111/ene.14444
pubmed: 32681611