%0 Journal Article
%T Clindamycin clearance during Cytosorb£¿ hemoadsorption: A case report and pharmacokinetic study
%A Antoine Guillaume Schneider
%A Chiara Simoni
%A David Longchamp
%A Elettra Camille Poli
%A Marie-H¨¦l¨¨ne Perez
%A Pascal Andr¨¦
%A Thierry Buclin
%A Thomas Ferry
%J The International Journal of Artificial Organs
%@ 1724-6040
%D 2019
%R 10.1177/0391398819831303
%X Panton-Valentine leucocidin producing methicillin-resistant Staphylococcus aureus infections are rare but associated with very high mortality rates. We report the case of a 14-year-old patient with Panton-Valentine leucocidin producing methicillin-resistant Staphylococcus aureus infection and Influenza B pneumonia requiring veno-arterial extra-corporeal membrane oxygenator for refractory shock. In the absence of response to conventional therapy, we have inserted a Cytosorb£¿ cartridge within the extra-corporeal membrane oxygenator circuit. A spectacular decrease in vasopressor requirements followed. Since clindamycin, a key component of Panton-Valentine leucocidin producing methicillin-resistant Staphylococcus aureus treatment, might be removed by Cytosorb£¿ hemoadsorption, we have performed serial plasma concentrations measurements of the drug. Based on these measurements, we were able to develop a pharmacokinetic model incorporating variable plasma clearance. Patient¡¯s exposure was estimated before, during and after Cytosorb£¿ hemoadsorption. According to this model, Cytosorb£¿ hemoadsorption did not seem to result in significant clindamycin removal. Cytosorb£¿ hemoadsorption during Panton-Valentine leucocidin producing methicillin-resistant Staphylococcus aureus infection appears safe and feasible and no adaptation of clindamycin dosage seems necessar
%K Adsorbents
%K antibiotics
%K hemoperfusion
%K infection
%K paediatric ECMO
%K plasma clearance
%K sepsis
%K treatment of bacterial infections
%K artificial kidney
%K apheresis & detoxification techniques
%U https://journals.sagepub.com/doi/full/10.1177/0391398819831303