Objective: To assess the pharmacokinetics of a single dose of teicoplanin in critically ill patients treated with continuous arteriovenous haemofiltration (CAVH).
Study design: Prospective open clinical study.
Patients: Eleven patients with acute renal insufficiency and suspected of a Gram negative infection.
Method: After injection of teicoplanin, 6 mg.kg-1 over 30 minutes the plasma and haemofiltrate concentrations were measured over 24 hours with high power liquid chromatography (HPLC).
Results: In plasma, the mean half-life of the first phase was 0.6 +/- 0.2 hour and terminal half-life was 16.4 +/- 5 8 hours, total clearance 30.4 +/- 7.1 mL.h-1.kg-1, volume of distribution was 0.7 +/- 0.3 L.kg-1 and the mean resident time 19.2 +/- 7.4 hours. In the haemofiltrate, the amount of teicoplanin eliminated after 24 hours was less than 1% in seven patients, between 1.8 and 3.7% in three and reached 7% in one patient.
Conclusion: During CAVH, the elimination of a single dose of teicoplanin in the haemofiltrate is low.