Pharmacokinetics of Commonly Used Antimicrobials in Critically Ill Adults During Extracorporeal Membrane Oxygenation: A Systematic Review.
| Title: | Pharmacokinetics of Commonly Used Antimicrobials in Critically Ill Adults During Extracorporeal Membrane Oxygenation: A Systematic Review. |
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| Authors: | Duceppe MA; Department of Pharmacy, McGill University Health Centre, 1001 Boul. Décarie, Local C-RC 6004, Montreal, QC, H4A 3J1, Canada. duceppe.marc.alexandre@gmail.com.; Kanji S; Department of Pharmacy, The Ottawa Hospital, Ottawa, Canada.; Faculty of Medicine, University of Ottawa, Ottawa, Canada.; Faculté de Pharmacie, Université de Montréal, Montreal, Canada.; Do AT; Department of Pharmacy, McGill University Health Centre, 1001 Boul. Décarie, Local C-RC 6004, Montreal, QC, H4A 3J1, Canada.; Ruo N; Department of Pharmacy, McGill University Health Centre, 1001 Boul. Décarie, Local C-RC 6004, Montreal, QC, H4A 3J1, Canada.; Cavayas YA; Department of Medicine, Division of Critical Care, Hôpital du Sacré-Coeur de Montréal Research Centre, Montreal, Canada.; Department of Surgery, Division of Critical Care, Montreal Heart Institute, Montreal, Canada.; Département de Médecine, Faculté de Médecine, Université de Montréal, Montreal, Canada.; Albert M; Department of Medicine, Division of Critical Care, Hôpital du Sacré-Coeur de Montréal Research Centre, Montreal, Canada.; Department of Surgery, Division of Critical Care, Montreal Heart Institute, Montreal, Canada.; Département de Médecine, Faculté de Médecine, Université de Montréal, Montreal, Canada.; Robert-Halabi M; Department of Medicine, Division of Cardiology, Centre Hospitalier de l'Université de Montréal, Montreal, Canada.; Zavalkoff S; Department of Pediatrics, Division of Pediatric Critical Care, McGill University Health Centre, Montreal, Canada.; Faculty of Medicine, McGill University, Montreal, Canada.; Dupont P; Bibliothèque de la santé, Université de Montréal, Montreal, Canada.; Samoukovic G; Faculty of Medicine, McGill University, Montreal, Canada.; Department of Surgery, Division of Critical Care, McGill University Health Centre, Montreal, Canada.; Williamson DR; Faculté de Pharmacie, Université de Montréal, Montreal, Canada.; Department of Pharmacy, Hôpital du Sacré-Coeur de Montréal, Montreal, Canada. |
| Source: | Drugs [Drugs] 2021 Jul; Vol. 81 (11), pp. 1307-1329. Date of Electronic Publication: 2021 Jul 05. |
| Publication Type: | Systematic Review; Journal Article |
| Language: | English |
| Journal Info: | Publisher: Adis, Springer International Country of Publication: New Zealand NLM ID: 7600076 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1179-1950 (Electronic) Linking ISSN: 00126667 NLM ISO Abbreviation: Drugs Subsets: MEDLINE |
| Imprint Name(s): | Publication: Auckland : Adis, Springer International; Original Publication: New York, ADIS Press [etc.] |
| MeSH Terms: | Extracorporeal Membrane Oxygenation*; Anti-Infective Agents/*administration & dosage ; Anti-Infective Agents/*pharmacology; Anti-Infective Agents/pharmacokinetics ; Renal Replacement Therapy/methods ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Comorbidity ; Critical Illness ; Dose-Response Relationship, Drug ; Drug Monitoring ; Female ; Humans ; Male ; Middle Aged ; Organ Dysfunction Scores ; Patient Acuity ; Young Adult |
| Abstract: | Purpose: Adequate dosing of antimicrobials is critical to properly treat infections and limit development of resistance and adverse effects. Limited guidance exists for antimicrobial dosing adjustments in patients requiring extracorporporeal membrane oxygenation (ECMO) therapy. A systematic review was conducted to delineate the pharmacokinetics (PK) and pharmacodynamics (PD) of antimicrobials in critically ill adult patients requiring ECMO.; Methods: Medline, EMBASE, Global Health, and All EBM Reviews databases were searched. Grey literature was examined. All studies reporting PK/PD parameters of antimicrobials in critically ill adults treated with ECMO were included, except for case reports and congress abstracts. Ex vivo studies were included. Two independent reviewers applied the inclusion and exclusion criteria. Reviewers were then paired to independently abstract data and evaluate methodological quality of studies using the ROBINS-I tool and the compliance with ClinPK guidelines. Patients' and studies' characteristics, key PK/PD findings, details of ECMO circuits and co-treatments were summarized qualitatively. Dosing recommendations were formulated based on data from controlled studies.; Results: Thirty-two clinical studies were included; most were observational and uncontrolled. Fourteen ex vivo studies were analysed. Information on patient characteristics and co-treatments was often missing. The effect of ECMO on PK/PD parameters of antimicrobials varied depending on the studied drugs. Few dosing recommendations could be formulated given the lack of good quality data.; Conclusion: Limited data exist on the PK/PD of antimicrobials during ECMO therapy. Rigorously designed and well powered populational PK studies are required to establish empiric dosing guidelines for antimicrobials in patients requiring ECMO support.; Prospero Registration Number: CRD42018099992 (Registered: July 24th 2018).; (© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.) |
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(PMID: 10.1186/1471-2253-13-7235173113643838) |
| Substance Nomenclature: | 0 (Anti-Infective Agents) |
| Entry Date(s): | Date Created: 20210705 Date Completed: 20211215 Latest Revision: 20211215 |
| Update Code: | 20260130 |
| DOI: | 10.1007/s40265-021-01557-3 |
| PMID: | 34224115 |
| Database: | MEDLINE |
Systematic Review; Journal Article