Journal article
Beta-lactam carryover in arterial and central venous catheters is negligible
Clinica chimica acta, Vol.486, pp.265-268
11/2018
DOI: 10.1016/j.cca.2018.08.008
PMCID: PMC8627117
PMID: 30118674
Abstract
Therapeutic drug monitoring is used for aminoglycosides and vancomycin, and has been proposed for β-lactam antibiotics. Clinical blood samples in the ICU are often obtained via an existing vascular catheter rather than fresh needle phlebotomy. If antibiotics had previously been infused through a vascular catheter then used for blood sampling, carryover of antibiotic from the infusion to the sample might result in misleading assessments of target attainment. To address this concern we conducted a series of in vitro measurements of carryover for three commonly used antibiotics.
We infused piperacillin-tazobactam, meropenem, and cefepime at pharmacologic concentrations through commonly used vascular catheters at our hospital and flushed the catheters. We then aspirated warmed citrated bovine blood through each catheter and measured antibiotic concentrations in each aspirate.
Carryover was below the limits of detection for piperacillin-tazobactam, meropenem, and vancomycin. Cefepime carryover, in contrast, was not negligible and needs to be investigated more fully.
Carryover from prior infusions does not appear to jeopardize measurements of piperacillin-tazobactam, meropenem, or vancomycin in commonly used vascular catheters at our institution. Caution in interpreting samples obtained for cefepime measurements appears advised until more data is available.
•Carryover of piperacillin, meropenem, and vancomycin was negligible in samples drawn through triple-lumen and peripherally-inserted central catheters (PICC) vascular access devices.•Carryover of cefepime in vascular access devices appears to be sufficient to confound drug concentration measurements by as much as the expected trough concentration.•Clinical pharmacokinetics of piperacillin-tazobactam, meropenem, and vancomycin may be measured using indwelling vascular catheters.•When conducting pharmacokinetic studies of cefepime, it appears prudent to ensure that the sampling catheter is not also being used for cefepime infusion.
Details
- Title: Subtitle
- Beta-lactam carryover in arterial and central venous catheters is negligible
- Creators
- Emily Marsh - Vanderbilt University Medical CenterSylvia M. Verhoven - Vanderbilt University Medical CenterJoseph J. Groszek - Vanderbilt University Medical CenterWilliam H. Fissell - Vanderbilt University Medical CenterGuohua An - University of IowaPratish Patel - Vanderbilt University Medical CenterBuddy Creech - Vanderbilt University Medical CenterMatthew Shotwell - Vanderbilt University Medical Center
- Resource Type
- Journal article
- Publication Details
- Clinica chimica acta, Vol.486, pp.265-268
- DOI
- 10.1016/j.cca.2018.08.008
- PMID
- 30118674
- PMCID
- PMC8627117
- NLM abbreviation
- Clin Chim Acta
- ISSN
- 0009-8981
- eISSN
- 1873-3492
- Publisher
- Elsevier B.V
- Grant note
- DOI: 10.13039/100006537, name: Vanderbilt University, award: HHSN272201300023I; DOI: 10.13039/100008893, name: University of Iowa, award: HHSN2722013000201
- Language
- English
- Date published
- 11/2018
- Academic Unit
- Pharmaceutical Sciences and Experimental Therapeutics
- Record Identifier
- 9984366015902771
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