A Systematic Review of Linezolid Pharmacokinetics/Pharmacodynamics in Patients Undergoing Continuous Renal Replacement Therapy : Does One Size Fit All?

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BACKGROUND: Selection of the optimal antimicrobial posology in critically ill patients remains a challenge, especially in patients with sepsis who undergo continuous renal replacement therapy (CRRT). This systematic review aimed to analyze factors that influence the extracorporeal removal of linezolid.

METHODS: A comprehensive search was performed to identify studies published up to March 2022 in PubMed, MEDLINE and EMBASE databases. Studies involving adults receiving CRRT and treatment with linezolid were considered eligible if the CRRT setting and linezolid's pharmacokinetic parameters were clearly mentioned.

RESULTS: Six out of 110 potentially relevant studies were included. A total of 101 treatments were identified among 97 enrolled patients. Our analysis showed that continuous veno-venous hemodiafiltration (CVVHDF) was the most frequential used modality (52 cases). Despite distribution volume, the clearance (CL) of linezolid in these studies had large variability. Extracorporeal linezolid removal may be markedly impacted by CRRT dose. There is significant between-subject variability in the probability of pharmacokinetics-pharmacodynamics (PK-PD) target attainment of patients treated with CRRT.

CONCLUSION: Dose adjustment, shortening the dosing interval, and continuous infusion were proposed as regimen optimization. Therapeutic drug monitoring is recommended due to the high variability of linezolid exposure among patients with CRRT, specifically for those whose bodyweight is high, renal function is preserved, and the MIC of infection bacteria is above 2 μg/mL.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:24

Enthalten in:

Current drug metabolism - 24(2023), 1 vom: 28., Seite 70-77

Sprache:

Englisch

Beteiligte Personen:

Liu, Yao [VerfasserIn]
Ge, Xu-Hua [VerfasserIn]
Guo, Hong-Li [VerfasserIn]
Chen, Feng [VerfasserIn]
Zhang, Yong [VerfasserIn]
Xu, Jing [VerfasserIn]
Ji, Xing [VerfasserIn]
Miao, Hong-Jun [VerfasserIn]

Links:

Volltext

Themen:

Anti-Bacterial Agents
Anti-Infective Agents
Antimicrobial posology
CVVHDF
Dose regimen
ISQ9I6J12J
Journal Article
Linezolid
Pharmacokinetics/pharmacodynamics
Renal replacement therapy
Systematic Review

Anmerkungen:

Date Completed 17.05.2023

Date Revised 17.05.2023

published: Print

Citation Status MEDLINE

doi:

10.2174/1389200224666221228144117

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM350907706