Comparison of Intravenous Microdialysis and Standard Plasma Sampling for Monitoring of Vancomycin and Meropenem Plasma Concentrations—An Experimental Porcine Study

Microdialysis is a catheter-based method suitable for dynamic sampling of unbound antibiotic concentrations. Intravenous antibiotic concentration sampling by microdialysis has several advantages and may be a superior alternative to standard plasma sampling. We aimed to compare concentrations obtained by continuous intravenous microdialysis sampling and by standard plasma sampling of both vancomycin and meropenem in a porcine model. Eight female pigs received 1 g of both vancomycin and meropenem, simultaneously over 100 and 10 min, respectively. Prior to drug infusion, an intravenous microdialysis catheter was placed in the subclavian vein. Microdialysates were collected for 8 h. From a central venous catheter, plasma samples were collected in the middle of every dialysate sampling interval. A higher area under the concentration/time curve and peak drug concentration were found in standard plasma samples compared to intravenous microdialysis samples, for both vancomycin and meropenem. Both vancomycin and meropenem concentrations obtained with intravenous microdialysis were generally lower than from standard plasma sampling. The differences in key pharmacokinetic parameters between the two sampling techniques underline the importance of further investigations to find the most suitable and reliable method for continuous intravenous antibiotic concentration sampling.

[1]  S. Wicha,et al.  Pilot Pharmacokinetic Study in Healthy Adults Using Intravascular Microdialysis Catheters Modified for Use in Paediatric Patients to Assess Vancomycin Blood Levels , 2022, Clinical Pharmacokinetics.

[2]  S. Wicha,et al.  Comparison of ultrafiltration and microdialysis for ceftriaxone protein-binding determination. , 2022, Journal of Antimicrobial Chemotherapy.

[3]  M. Bue,et al.  Concentrations of co-administered vancomycin and meropenem in the internal dead space of a cannulated screw and in cancellous bone adjacent to the screw - Evaluated by microdialysis in a porcine model. , 2022, Injury.

[4]  M. Bue,et al.  Tibial bone and soft-tissue concentrations following combination therapy with vancomycin and meropenem – evaluated by microdialysis in a porcine model , 2022, Bone & joint research.

[5]  N. El-Najjar,et al.  Efficacy of Vancomycin and Meropenem in Central Nervous System Infections in Children and Adults: Current Update , 2022, Antibiotics.

[6]  C. Kloft,et al.  Microdialysis sampling to monitor target-site vancomycin concentrations in septic infants - a feasible way to close the knowledge gap. , 2021, International journal of antimicrobial agents.

[7]  B. Claus,et al.  Vancomycin dosing and therapeutic drug monitoring practices: guidelines versus real-life , 2021, International Journal of Clinical Pharmacy.

[8]  Yibo Fei,et al.  A fast and high-sensitivity liquid chromatography-tandem mass spectrometry method combined with in vivo microdialysis for quantification of meropenem in rabbits with sepsis under the simultaneous infusion of total parenteral nutrition: Application to a pharmacokinetic study. , 2021, Biomedical chromotography.

[9]  F. Baldini,et al.  Immunosuppressant quantification in intravenous microdialysate – towards novel quasi-continuous therapeutic drug monitoring in transplanted patients , 2020, Clinical chemistry and laboratory medicine.

[10]  J. Roberts,et al.  Towards precision medicine: Therapeutic drug monitoring-guided dosing of vancomycin and β-lactam antibiotics to maximize effectiveness and minimize toxicity. , 2020, American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists.

[11]  D. Levine,et al.  Therapeutic monitoring of vancomycin for serious methicillin-resistant Staphylococcus aureus infections: A revised consensus guideline and review by the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the Socie , 2020, American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists.

[12]  M. Bue,et al.  Single-dose pharmacokinetics of meropenem in porcine cancellous bone determined by microdialysis , 2019, Bone & joint research.

[13]  M. Nijsten,et al.  In vitro evaluation of an intravenous microdialysis catheter for therapeutic drug monitoring of gentamicin and vancomycin , 2019, Pharmacology research & perspectives.

[14]  M. Bue,et al.  Vancomycin concentrations in the cervical spine after intravenous administration: results from an experimental pig study , 2018, Acta orthopaedica.

[15]  M. Bue,et al.  Population Pharmacokinetics of Meropenem in Plasma and Subcutis from Patients on Extracorporeal Membrane Oxygenation Treatment , 2018, Antimicrobial Agents and Chemotherapy.

[16]  J. Hanouz,et al.  Assessment of changes in blood glucose concentration with intravascular microdialysis , 2018, Journal of Clinical Monitoring and Computing.

[17]  E. Lorne,et al.  Assessment of changes in lactate concentration with intravascular microdialysis during high-risk cardiac surgery using the trend interchangeability method , 2017, British journal of anaesthesia.

[18]  M. Hammarlund-Udenaes Microdialysis as an Important Technique in Systems Pharmacology—a Historical and Methodological Review , 2017, The AAPS Journal.

[19]  Z. Ahmad,et al.  A Review on Microdialysis Calibration Methods: the Theory and Current Related Efforts , 2017, Molecular Neurobiology.

[20]  M. Bue,et al.  Single-dose pharmacokinetics of vancomycin in porcine cancellous and cortical bone determined by microdialysis. , 2015, International journal of antimicrobial agents.

[21]  Shuo Zhang,et al.  The effect of borneol on the concentration of meropenem in rat brain and blood , 2014, Journal of Asian natural products research.

[22]  J. Wernerman,et al.  Continuous glucose monitoring by intravenous microdialysis: influence of membrane length and dialysis flow rate , 2013, Acta anaesthesiologica Scandinavica.

[23]  J. Wernerman,et al.  Continuous glucose monitoring by intravenous microdialysis , 2010, Acta anaesthesiologica Scandinavica.

[24]  L. Rydén,et al.  Glucose monitoring by means of an intravenous microdialysis catheter technique. , 2010, Diabetes technology & therapeutics.

[25]  S. Läer,et al.  Development of an intravenous microdialysis method for pharmacokinetic investigations in humans. , 2005, Journal of pharmacological and toxicological methods.

[26]  F. Tison,et al.  Clinical drug monitoring by microdialysis: application to levodopa therapy in Parkinson's disease. , 2003, British Journal of Clinical Pharmacology.

[27]  R. Verbeeck Blood microdialysis in pharmacokinetic and drug metabolism studies. , 2000, Advanced drug delivery reviews.

[28]  W. Elmquist,et al.  The Design and Validation of a Novel Intravenous Microdialysis Probe: Application to Fluconazole Pharmacokinetics in the Freely-Moving Rat Model , 1997, Pharmaceutical Research.

[29]  R. Newman,et al.  The Use of Microdialysis in Pharmacokinetics and Pharmacodynamics , 1997, Pharmacotherapy.

[30]  Jan Kehr,et al.  A survey on quantitative microdialysis: theoretical models and practical implications , 1993, Journal of Neuroscience Methods.

[31]  Y. Saisho,et al.  Continuous monitoring of unbound flomoxef levels in rat blood using microdialysis and its new pharmacokinetic analysis. , 1991, Chemical & pharmaceutical bulletin.

[32]  Eva Benfeldt,et al.  AAPS-FDA Workshop White Paper: Microdialysis Principles, Application and Regulatory Perspectives , 2006, Pharmaceutical Research.

[33]  Markus Müller,et al.  Microdialysis: current applications in clinical pharmacokinetic studies and its potential role in the future. , 2005, Clinical pharmacokinetics.

[34]  U. Ungerstedt,et al.  Chemical monitoring of intensive care patients using intravenous microdialysis , 2005, Intensive Care Medicine.