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01-12-2015 | Letter

The blind spot in high-dose tigecycline pharmacokinetics in critically ill patients: membrane adsorption during continuous extracorporeal treatment

Authors: Patrick M Honore, Rita Jacobs, Elisabeth De Waele, Viola Van Gorp, Herbert D Spapen

Published in: Critical Care | Issue 1/2015

Excerpt

We read with interest the paper by De Pascale and colleagues [1] and the accompanying editorial [2] on high-dose tigecycline (TGC) in critically ill patients with severe infections due to multidrug-resistant bacteria. We agree that the currently recommended TGC dose (100 mg loading followed by 50 mg twice daily) may be largely insufficient for treatment of such infections and may promote resistance. In line with pharmacological logic, De Pascale and colleagues showed that increasing the TGC dose improved clinical outcome without enhancing toxicity. Interestingly, 25% of the patients included in their study received continuous renal replacement therapy. Details of and the distribution of continuous renal replacement therapy between groups were not provided. …

De Pascale G, Montini L, Pennisi M, Bernini V, Maviglia R, Bello G, et al. High dose tigecycline in critically ill patients with severe infections due to multidrug-resistant bacteria. Crit Care. 2014;18:R90.CrossRef

Garnacho-Montero J, Ferrándiz-Millón C. High dose of tigecycline for extremely resistant Gram-negative pneumonia: yes, we can. Crit Care. 2014;18:157.CrossRef

Mehta NM, Halwick DR, Dodson BL, Thompson JE, Arnold JH. Potential drug sequestration during extracorporeal membrane oxygenation: results from an ex vivo experiment. Intensive Care Med. 2007;33:1018–24.CrossRef

Korth-Bradley JM, Troy SM, Matschke K, Muralidharan G, Fruncillo RJ, Speth JL, et al. Tigecycline pharmacokinetics in subjects with various degrees of renal function. J Clin Pharmacol. 2012;52:1379–87.CrossRef

Honore PM, Jacobs R, Joannes-Boyau O, De Regt J, De Waele E, van Gorp V, et al. Newly designed CRRT membranes for sepsis and SIRS – a pragmatic approach for bedside intensivists summarizing the more recent advances: a systematic structured review. ASAIO J. 2013;59:99–106.CrossRef

Honore PM, Jacobs R, Spapen HD. Antimicrobial dosing during extracorporeal membrane oxygenation. In Annual Update in Intensive Care and Emergency Medicine. Edited by Vincent J-L. Springer; 2014:43–52.

Title: The blind spot in high-dose tigecycline pharmacokinetics in critically ill patients: membrane adsorption during continuous extracorporeal treatment
Authors: Patrick M Honore
Rita Jacobs
Elisabeth De Waele
Viola Van Gorp
Herbert D Spapen
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: Critical Care / Issue 1/2015
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/s13054-015-0744-9

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The blind spot in high-dose tigecycline pharmacokinetics in critically ill patients: membrane adsorption during continuous extracorporeal treatment

Excerpt

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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