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- Title
Clindamycin clearance during Cytosorb<sup>®</sup> hemoadsorption: A case report and pharmacokinetic study.
- Authors
Poli, Elettra Camille; Simoni, Chiara; André, Pascal; Buclin, Thierry; Longchamp, David; Perez, Marie-Hélène; Ferry, Thomas; Schneider, Antoine Guillaume
- Abstract
Panton-Valentine leucocidin producing methicillin-resistant Staphylococcus aureus infections are rare but associated with very high mortality rates. We report the case of a 14-year-old patient with Panton-Valentine leucocidin producing methicillin-resistant Staphylococcus aureus infection and Influenza B pneumonia requiring veno-arterial extra-corporeal membrane oxygenator for refractory shock. In the absence of response to conventional therapy, we have inserted a Cytosorb® cartridge within the extra-corporeal membrane oxygenator circuit. A spectacular decrease in vasopressor requirements followed. Since clindamycin, a key component of Panton-Valentine leucocidin producing methicillin-resistant Staphylococcus aureus treatment, might be removed by Cytosorb® hemoadsorption, we have performed serial plasma concentrations measurements of the drug. Based on these measurements, we were able to develop a pharmacokinetic model incorporating variable plasma clearance. Patient's exposure was estimated before, during and after Cytosorb® hemoadsorption. According to this model, Cytosorb® hemoadsorption did not seem to result in significant clindamycin removal. Cytosorb® hemoadsorption during Panton-Valentine leucocidin producing methicillin-resistant Staphylococcus aureus infection appears safe and feasible and no adaptation of clindamycin dosage seems necessary.
- Publication
International Journal of Artificial Organs, 2019, Vol 42, Issue 5, p258
- ISSN
0391-3988
- Publication type
journal article
- DOI
10.1177/0391398819831303