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Journal of Antimicrobial Chemotherapy (2000) 45, 701-704
© 2000 The British Society for Antimicrobial Chemotherapy

Brief reports

Elimination of meropenem during continuous veno-venous haemofiltration and haemodiafiltration in patients with acute renal failure

Matti Valtonena,*, Eero Tiulab, Janne T. Backmanc and Pertti J. Neuvonenc

a Department of Medicine, Divisions of Infectious Diseases and b Nephrology, Helsinki University Central Hospital, Helsinki; c Department of Clinical Pharmacology, University of Helsinki, Helsinki, Finland

Meropenem elimination was studied in six patients with acute renal failure on continuous venovenous haemofiltration (CVVH) or continuous veno-venous haemodiafiltration (CVVHDF) 1 L/h and 2 L/h for 12 h. Meropenem 1 g was given iv over three dialysis periods, and plasma, ultrafiltrate/dialysate and urine concentrations of meropenem were determined. The half-life of meropenem was significantly longer (P < 0.05) during CVVH (7.5 ± 2.0 h; mean ± S.D.) than during CVVHDF 1 L/h (5.6 ± 1.4 h) or 2 L/h (4.8 ± 1.2 h). Meropenem clearance was 3.27 ± 2.30 L/h, 4.72 ± 2.69 L/h and 5.71 ± 3.58 L/h in CVVH, CVVHDF 1 L/h and CVVHDF 2 L/h, respectively (P < 0.05 between CVVH and CVVHDF). Patients with renal failure on CVVHDF 1 or 2 L/h should be treated with meropenem 1 g bid; 500 mg tid may be enough for patients on CVVH.

* Correspondence address. Department of Medicine, Helsinki University Central Hospital, Haartmaninkatu 4, PO Box 340, FIN-00029 HYKS, Finland. Tel: +358-9-471-73573; Fax: +358-9-471-74013; E-mail: matti.valtonen{at}huch.fi


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