• Wanchana Singhan, Somratai Vadcharavivad, Nutthada Areepium, Supeecha Wittayalertpanya, Weerachai Chaijamorn, and Nattachai Srisawat.
• Department of Pharmacy Practice, Faculty of Pharmaceutical Science, Chulalongkorn University, Bangkok 10330, Thailand; Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand. Electronic address: wanchana.s@cmu.ac.th.
• J Crit Care. 2019 Jun 1; 51: 71-76.

PurposeTo evaluate the effect of direct hemoperfusion with polymyxin B immobilized cartridge (DHP-PMX) on meropenem pharmacokinetics in critically ill patients with sepsis requiring continuous venovenous hemofiltration (CVVH).Material And MethodsAfter intravenous infusion of 1 g meropenem over 3 h repeated every 8 h for at least 3 doses, 2 serial blood and ultrafiltration fluid samples were collected: one over a dose interval of meropenem with DHP-PMX therapy; and the other on the following day over a dose interval of meropenem with no DHP-PMX therapy. Meropenem concentrations were measured by high performance liquid chromatography. Pharmacokinetic parameters of meropenem and extraction ratio of DHP-PMX were calculated.ResultsMean AUC0-8 of meropenem on DHP-PMX day was comparable to that of the DHP-PMX free day (285.2 ± 138.2 vs 297.8 ± 130.2 mg ∗ h/L; paired t-test, p = .618). No statistical significance of peak and trough concentrations, volume of distribution, sieving coefficient, or half-life were found. Extraction ratio of DHP-PMX on meropenem was 0 [0-0.03] and clearance by DHP-PMX was 0.04 [0-0.2] L/h which was not considered clinically significant.ConclusionsNo significant effect of DHP-PMX on meropenem pharmacokinetics was observed among severe sepsis/septic shock patients during CVVH treatment.Trial RegistrationClinical Trial Registry detail: NCT registry: 02413541 (First registered March 3, 2015, last update October 16, 2017).Copyright © 2019 Elsevier Inc. All rights reserved.

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