Meropenem pharmacokinetics in children and adolescents receiving hemodialysis

S. L. Goldstein, Daryl J Murry, S. May, A. Aleksic, K. M. Sowinski, S. Blaney

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

The emergence of multi-drug-resistant bacteria is of great concern to the care of pediatric end-stage renal disease (ESRD) patients who receive either hemodialysis or peritoneal dialysis via a catheter. Infections with gram-negative organisms, especially Pseudomonas aeruginosa, are difficult to eradicate and often necessitate catheter removal. Meropenem, a broad-spectrum antibiotic of the carbapenem class of beta-lactams, is effective against most gram-positive and gram-negative bacteria and has enhanced activity against P. aeruginosa. We studied the pharmacokinetics of meropenem during and between hemodialysis treatments in seven pediatric patients. Meropenem was given as a single dose of 20 mg/kg (maximum 500 mg) before and after two separate hemodialysis treatments. Meropenem administration was tolerated without any adverse effects. Hemodialysis effectively cleared meropenem in a manner that correlated with percent urea reduction. Median drug half-life was 7.3 h off dialysis (range 4.9-11.7 h). The dose of 20 mg/kg was not sufficient to produce an acceptable interdialytic pharmacodynamic profile of 70% duration with a meropenem concentration >4 μg/ml, the MIC90 of meropenem for P. aeruginosa. Dosing simulations revealed that a daily dose of 25 mg/kg or an alternate day dose of 40 mg/kg would result in an acceptable pharmacodynamic profile. Both simulated doses achieved acceptable peak concentrations.

Original languageEnglish (US)
Pages (from-to)1015-1018
Number of pages4
JournalPediatric Nephrology
Volume16
Issue number12
DOIs
StatePublished - Dec 1 2001

Fingerprint

meropenem
Renal Dialysis
Pharmacokinetics
Pseudomonas aeruginosa
Catheters
Pediatrics
Carbapenems
beta-Lactams
Peritoneal Dialysis
Gram-Negative Bacteria
Pharmaceutical Preparations
Chronic Kidney Failure
Half-Life
Urea
Dialysis

Keywords

  • Children
  • Hemodialysis
  • Meropenem
  • Pharmacokinetics
  • Renal failure

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Nephrology

Cite this

Goldstein, S. L., Murry, D. J., May, S., Aleksic, A., Sowinski, K. M., & Blaney, S. (2001). Meropenem pharmacokinetics in children and adolescents receiving hemodialysis. Pediatric Nephrology, 16(12), 1015-1018. https://doi.org/10.1007/s004670100015

Meropenem pharmacokinetics in children and adolescents receiving hemodialysis. / Goldstein, S. L.; Murry, Daryl J; May, S.; Aleksic, A.; Sowinski, K. M.; Blaney, S.

In: Pediatric Nephrology, Vol. 16, No. 12, 01.12.2001, p. 1015-1018.

Research output: Contribution to journalArticle

Goldstein, SL, Murry, DJ, May, S, Aleksic, A, Sowinski, KM & Blaney, S 2001, 'Meropenem pharmacokinetics in children and adolescents receiving hemodialysis', Pediatric Nephrology, vol. 16, no. 12, pp. 1015-1018. https://doi.org/10.1007/s004670100015
Goldstein, S. L. ; Murry, Daryl J ; May, S. ; Aleksic, A. ; Sowinski, K. M. ; Blaney, S. / Meropenem pharmacokinetics in children and adolescents receiving hemodialysis. In: Pediatric Nephrology. 2001 ; Vol. 16, No. 12. pp. 1015-1018.
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