Pharmacokinetics of Vancomycin in the ICU in Renal Replacement Therapy

NCT ID: NCT00848809

Last Updated: 2015-04-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

WITHDRAWN

Study Classification

OBSERVATIONAL

Study Start Date

2008-12-31

Study Completion Date

2009-04-30

Brief Summary

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This study is an observational analysis that monitors the effect of different dialysis methods on vancomycin levels when patients are critically ill. No changes are made to therapy based on levels, but levels are checked more frequently than normal. The primary dialysis methods being studied are SLED (slow-low efficiency daily) dialysis and intermittent hemodialysis. Vancomycin is the only medication being evaluated in this study. This study will provide detailed information on how to dose vancomycin in patients that are on dialysis in the intensive care unit.

Detailed Description

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The proposed study will evaluate the pharmacokinetics of vancomycin in patients that are on being treated with various types of renal replacement therapy. The renal replacement therapies studied in this trial will be slow-low efficiency daily (SLED) dialysis and intermittent hemodialysis. This data will be collected and plotted for vancomycin for each dialysis mechanism utilized and plotted on drug concentration versus time graphs to determine drug clearance in each type of renal replacement therapy. Subjects will have blood samples drawn and sent to the laboratory according to the dialysis method studied (9 for SLED dialysis and 10 samples for intermittent hemodialysis). Serial levels will be drawn prior to the drug being administered and after the drug is infused to assess the clearance and distribution of vancomycin. Study drug levels will be drawn from blood that is already available in the laboratory when timing of such samples is appropriate, in order to limit the amount of blood that is drawn from each study subject. A total of 30 milliliters of blood will be collected from each subject for any one study arm they fit into. Blood will be collected no more than two times per week and only more than once in a particular patient if their dialysis regimen changes. A single particular subject will only be able to supply blood samples once for each dialysis regimen being studied. This study would allow for the data collection of vancomycin levels at several time points during renal replacement therapy to assess the pharmacokinetic parameters associated with vancomycin dosing in each specialized patient-dialysis combination.

Conditions

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Acute Kidney Injury

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

PROSPECTIVE

Study Groups

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1

Slow-low efficiency daily dialysis group

Blood sample

Intervention Type PROCEDURE

9 blood samples will be sent to the laboratory for the subjects in the SLED cohort

2

Intermittent Hemodialysis group

Blood sample

Intervention Type PROCEDURE

10 blood samples will be collected and sent to the laboratory for the subjects in the intermittent hemodialysis cohort.

Interventions

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Blood sample

9 blood samples will be sent to the laboratory for the subjects in the SLED cohort

Intervention Type PROCEDURE

Blood sample

10 blood samples will be collected and sent to the laboratory for the subjects in the intermittent hemodialysis cohort.

Intervention Type PROCEDURE

Other Intervention Names

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Vancomycin level Vancomycin level

Eligibility Criteria

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Inclusion Criteria

* \> 18 years of age
* One of the following types of dialysis modalities implemented:

Slow-low efficiency daily dialysis Intermittent hemodialysis

* Use of study medication (vancomycin)

Exclusion Criteria

* Inability to give informed consent
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Avera McKennan Hospital & University Health Center

OTHER

Sponsor Role lead

Responsible Party

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Avera McKennan Hospital and University Health Center

Principal Investigators

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Bradley Beck, Pharm.D.

Role: PRINCIPAL_INVESTIGATOR

Avera McKennan Hospital and University Health Center

Locations

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Avera McKennan Hospital and University Health Center

Sioux Falls, South Dakota, United States

Site Status

Countries

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United States

References

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Kielstein JT, Czock D, Schopke T, Hafer C, Bode-Boger SM, Kuse E, Keller F, Fliser D. Pharmacokinetics and total elimination of meropenem and vancomycin in intensive care unit patients undergoing extended daily dialysis. Crit Care Med. 2006 Jan;34(1):51-6. doi: 10.1097/01.ccm.0000190243.88133.3f.

Reference Type BACKGROUND
PMID: 16374156 (View on PubMed)

Trotman RL, Williamson JC, Shoemaker DM, Salzer WL. Antibiotic dosing in critically ill adult patients receiving continuous renal replacement therapy. Clin Infect Dis. 2005 Oct 15;41(8):1159-66. doi: 10.1086/444500. Epub 2005 Sep 12.

Reference Type BACKGROUND
PMID: 16163635 (View on PubMed)

Pai AB, Pai MP. Vancomycin dosing in high flux hemodialysis: a limited-sampling algorithm. Am J Health Syst Pharm. 2004 Sep 1;61(17):1812-6. doi: 10.1093/ajhp/61.17.1812.

Reference Type BACKGROUND
PMID: 15462252 (View on PubMed)

Other Identifiers

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2008.073

Identifier Type: -

Identifier Source: org_study_id

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