Linezolid Adsorption on Filters during Continuous Renal Replacement Therapy: An In Vitro Study

Krzysztof Nosek; Milena Samiec; Hubert Ziółkowski; Paulina Markowska-Buńka; Mirosław Czuczwar; Michał Borys; Dariusz Onichimowski

doi:10.3390/ph17101317

Pharmaceuticals (Oct 2024)

Linezolid Adsorption on Filters during Continuous Renal Replacement Therapy: An In Vitro Study

Krzysztof Nosek,
Milena Samiec,
Hubert Ziółkowski,
Paulina Markowska-Buńka,
Mirosław Czuczwar,
Michał Borys,
Dariusz Onichimowski

Affiliations

Krzysztof Nosek: Department of Pharmacology and Toxicology, Faculty of Medicine, University of Warmia and Mazury, Al. Warszawska 30, 10-082 Olsztyn, Poland
Milena Samiec: Department of Pharmacology and Toxicology, Faculty of Medicine, University of Warmia and Mazury, Al. Warszawska 30, 10-082 Olsztyn, Poland
Hubert Ziółkowski: Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, University of Warmia and Mazury, Oczapowskiego 13, 10-718 Olsztyn, Poland
Paulina Markowska-Buńka: Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, University of Warmia and Mazury, Oczapowskiego 13, 10-718 Olsztyn, Poland
Mirosław Czuczwar: 2nd Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, 20-059 Lublin, Poland
Michał Borys: 2nd Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, 20-059 Lublin, Poland
Dariusz Onichimowski: Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, University of Warmia and Mazury, Al. Warszawska 30, 11-082 Olsztyn, Poland

DOI: https://doi.org/10.3390/ph17101317
Journal volume & issue: Vol. 17, no. 10
p. 1317

Abstract

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Background: Renal replacement therapy (RRT), widely used in the treatment of renal injury during sepsis, aims to eliminate the toxins and proinflammatory cytokines involved in the pathomechanism underlying septic shock. Dialysis filters are characterized by a high adsorption potential for cytokines in RRT in the case of septic renal injury. For the treatment of sepsis with antibiotics, it is of key importance to achieve the desired values of PK/PD indices. Continuous renal replacement therapy (CRRT) may affect antimicrobial clearance, increasing their elimination in some cases. Methods: The aim of this study was to determine the degree of adsorption for linezolid on three different types of filters used in CRRT. In our in vitro study, a continuous veno-venous hemofiltration (CVVH) was conducted using three types of filters: polysulfone (PS), polyethyleneimine-treated polyacrylonitrile (PAN PEI), and non-PEI-treated polyacrylonitrile (PAN). Each type of filter was used in three CVVH cycles, involving the use of 600 mg of linezolid dissolved in 700 mL of bovine blood or in 700 mL of 0.9% NaCl. In each case, the total volume of the obtained solution was 1000 mL. Blood samples were collected at particular time points to measure their drug concentration. The differences in mean drug/NaCl adsorption and drug/blood adsorption were determined using a one-way ANOVA with multiple comparisons via Tukey’s post hoc test; a p-value of Results: A significant adsorption of linezolid was found for PAN PEI filters, both in samples obtained from bovine blood and 0.9% NaCl solutions, at the endpoint. In PAN PEI samples, the concentration of linezolid in 0.9% NaCl solutions decreased from 594.74 μg/mL to 310.66 μg/mL after 120 min (the difference was established at 52%). In blood samples, the initial concentration was 495.18 μg/mL, which then decreased to 359.84 μg/mL (73% of the beginning value). No significant adsorption was demonstrated on PAN or PS filters. Conclusion: There is a need for in vivo research to confirm the effect of filter type on linezolid concentration in patients undergoing CRRT.

Published in Pharmaceuticals

ISSN: 1424-8247 (Online)
Publisher: MDPI AG
Country of publisher: Switzerland
LCC subjects: Medicine: Pharmacy and materia medica
Website: http://www.mdpi.com/journal/pharmaceuticals/

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