The effect of renal replacement therapy on the concentration of tigecycline in the blood in patients with sepsis-associated acute kidney injury

Abstract

The objective was to evaluate the effect of renal replacement therapy on the concentration of tigecycline in the blood in the treatment of patients with sepsis and acute kidney injury.Materials and methods. The serum level of tigecycline was analyzed in three patients with sepsis-associated acute kidney injury against the back -ground of renal replacement therapy (RRT) in the hemodiafiltration mode. The quantitative content of tigecycline was determined by high-performance liquid chromatography.Results. Significant variability of serum tigecycline levels was revealed in patients with sepsis-associated acute kidney injury (AKI) under the conditions of the use of RRT. The use of standard dosage regimens of tigecycline in this situation may be accompanied by both a significant increase in the concentration of the drug in the blood relative to the target values, and its low level, which does not reach the values of the minimum inhibitory concentration (MIC) for pathogenic strains.Conclusion. Significant variability of serum concentrations of tigecycline in patients with sepsis-associated AKI against the background of RRT causes the emergence of potential risks associated with both insufficient safety of treatment due to possible accumulation and  significant excess of the target concentration value against the background of inhibition of the functions of the physiological excretory systems  of the body, so with the low effectiveness of antibacterial therapy in conditions of increasing the rate of elimination of the drug from the  systemic bloodstream due to extracorporeal clearance and reducing the concentration of the antibiotic to subtherapeutic.