Should we fear tubing adsorption of antibacterial drugs in extracorporeal membrane oxygenation? An answer for cephalosporins and carbapenems

Camille Tron (1, 2) , Cyril Leven (1, 2, 3, 4) , Pierre Fillâtre (2, 3, 4) , Nicolas Maillard (1) , Nicolas Nesseler (5, 6) , Pierre Tattevin (4, 7) , Erwan Flécher (8, 9) , Eric Bellissant (2, 4) , Marie-Clémence Verdier (2, 4) , Florian Lemaitre (2, 4)

1 CHU Pontchaillou [Rennes]
2 Department of clinical and biological pharmacology and pharmacovigilance
3 Laboratory of experimental and clinical pharmacology
4 CIC - Centre d'Investigation Clinique [Rennes]
5 Service d'anesthésie réanimation chirurgicale [Rennes]
6 Foie, métabolismes et cancer
7 Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes]
8 CIC-IT Rennes
9 Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes]

Extracorporeal membrane oxygenation (ECMO) procedure used in the management of patients with cardiac and/or respiratory failure could modify drugs pharmacokinetics (PK) properties. Studying the impact of ECMO devices on drugs PK is warranted to optimize dosage and ensure clinical outcomes. We aimed to characterize the behavior of four cephalosporins and three carbapenems commonly used in an ECMO circuit with an in-vitro approach focusing on the coated tubing, support of the extracorporeal circulation. Results suggest that these antibiotics are not sequestrated by ECMO tubing. This pilot mechanistic study provides original data that will contribute to improve our understanding of the impact of ECMO on the PK of drugs commonly used in intensive care unit patients.

Keywords: antibiotics; Adsorption; Extracorporeal Membrane Oxygenation; Intensive Care; pharmacokinetics

Domains: Life Sciences [q-bio]; Life Sciences [q-bio]; Pharmaceutical sciences; Pharmacology

Camille Tron, Cyril Leven, Pierre Fillâtre, Nicolas Maillard, Nicolas Nesseler, et al.. Should we fear tubing adsorption of antibacterial drugs in extracorporeal membrane oxygenation? An answer for cephalosporins and carbapenems. Clinical and Experimental Pharmacology and Physiology, 2016, 43 (2), pp.281-283. ⟨10.1111/1440-1681.12527⟩. ⟨hal-01255854⟩