Removal of doripenem during hemodialysis and the optimum dosing regimen for patients undergoing hemodialysis

Ther Apher Dial. 2011 Jun;15(3):327-33. doi: 10.1111/j.1744-9987.2011.00914.x. Epub 2011 Apr 28.

Abstract

The removal of doripenem by hemodialysis was studied in six hemodialysis patients. Following an intravenous drip infusion of 0.5 g of doripenem, plasma concentrations of the drug were measured. The decrease in drug concentrations in plasma was observed during various periods of non-hemodialysis, and hemodialysis accelerated the elimination of doripenem. For example, the calculated mean half-life during hemodialysis was significantly shorter than that during non-hemodialysis periods (P = 0.002). The calculated pharmacokinetic parameters indicated that the mean rate of decrease in plasma concentration due to hemodialysis alone was 56.12 ± 8.11%. Upon obtaining these results and several pharmacokinetic parameters, we attempted to optimize the dosing regimen of doripenem for hemodialysis patients. We recommend the use of 0.25 g of doripenem once a day in patients infected with viable bacteria, and in patients who are infected with Pseudomonas aeruginosa, 0.5 g twice a day on the first day of administration, followed by 0.5 g once a day.

MeSH terms

  • Aged
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / pharmacokinetics*
  • Carbapenems / administration & dosage
  • Carbapenems / pharmacokinetics*
  • Doripenem
  • Dose-Response Relationship, Drug
  • Female
  • Half-Life
  • Humans
  • Infusions, Intravenous
  • Male
  • Middle Aged
  • Pseudomonas Infections / drug therapy*
  • Pseudomonas Infections / microbiology
  • Pseudomonas aeruginosa / isolation & purification
  • Renal Dialysis / methods*

Substances

  • Anti-Bacterial Agents
  • Carbapenems
  • Doripenem