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Journal of Antimicrobial Chemotherapy (2002) 49, 129-134
© 2002 The British Society for Antimicrobial Chemotherapy

Clearance of ceftazidime during continuous venovenous haemofiltration in critically ill patients

Friederike Traunmüllera, Peter Schenkb, Christoph Mittermeyerb, Renate Thalhammer-Scherrerc, Klaus Ratheiserb and Florian Thalhammera,d,*

a Department of Internal Medicine I, Division of Infectious Diseases, b Department of Internal Medicine IV, Intensive Care Unit, c Department of Laboratory Medicine and d Department of Virology, University of Vienna, Waehringer Guertel 18–20, A-1090 Vienna, Austria

Published recommendations for the optimal dosing regimen of ceftazidime in critically ill patients with continuous venovenous haemofiltration (CVVH) differ. The aim of this prospective study was to analyse the pharmacokinetic and pharmacodynamic parameters of ceftazidime during CVVH with a high-flux polysulphone membrane, and derive a dosage recommendation. Twelve critically ill patients (five female, seven male) with acute renal failure undergoing CVVH using a 0.7 m2 polysulphone high-flux membrane were investigated. All patients received ceftazidime 2 g iv q8h. Peak ceftazidime concentrations were 58.2 ± 11.6 mg/L, with trough concentrations 14.0 ± 3.2 mg/L at the arterial port. The elimination half-life, haemofiltration clearance, volume of distribution and total removal were 4.3 ± 0.6 h, 32.1 ± 7.9 mL/min, 36.4 ± 6.4 L and 74.5 ± 6.5%, respectively. Based on these pharmacokinetic parameters and that maximal killing is at 4 x MIC we recommend at least ceftazidime 2 g iv q8h.

* Corresponding author. Tel: +43-1-40-400-4440; Fax: +49-89-2443-18-696; E-mail: florian.thalhammer{at}akh-wien.ac.at


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