Antibiotic Dosing in Patients on Intermittent Hemodialysis

NCT ID: NCT03909698

Last Updated: 2022-11-29

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

COMPLETED

Total Enrollment

150 participants

Study Classification

OBSERVATIONAL

Study Start Date

2016-09-15

Study Completion Date

2022-03-31

Brief Summary

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The adequacy of the currently used dosing regimen of glycopeptides (vancomycin and teicoplanin) and beta-lactam antibiotics (amoxicillin-clavulanic acid, piperacillin-tazobactam, ceftazidim) in patients with end-stage kidney disease receiving intermittent hemodialysis is studied by evaluating pharmacokinetics-pharmacodynamics (PK-PD) target attainment. A population pharmacokinetic study is performed to assist the selection of the optimal individualized dose for patients undergoing intermittent dialysis, taking into consideration as many relevant variables as possible.

Detailed Description

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Conditions

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Kidney Failure, Chronic Antibiotics Hemodialysis

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Hemodialysis patients on amoxicillin-clavulanic acid

The antibiotic administration protocol is not changed for this study. From the first administration on, administrations (dosage and duration) are well documented. Blood samples are taken as peak, distribution and trough samples during at least 24 or 48 hours. During the first dialysis session after study start, blood samples are also taken from the arterial and venous blood line simultaneously and at different dialysis time points, to calculate dialyzer extraction ratio. When appropriate, urine is collected during a documented period. During the second dialysis after study start, arterial and venous samples are taken for different dialysis settings, in order to calculate extraction ratios for different settings.

All blood and urine samples are analyzed for amoxicillin-clavulanic acid.

Blood and urine sampling

Intervention Type OTHER

During a period of maximum 6 days blood is sampled at different time points and urine is collected during documented time intervals.

Hemodialysis patients on ceftazidim

The antibiotic administration protocol is not changed for this study. From the first administration on, administrations (dosage and duration) are well documented. Blood samples are taken as peak, distribution and trough samples during at least 24 or 48 hours. During the first dialysis session after study start, blood samples are also taken from the arterial and venous blood line simultaneously and at different dialysis time points, to calculate dialyzer extraction ratio. When appropriate, urine is collected during a documented period. During the second dialysis after study start, arterial and venous samples are taken for different dialysis settings, in order to calculate extraction ratios for different settings.

All blood and urine samples are analyzed for ceftazidim.

Blood and urine sampling

Intervention Type OTHER

During a period of maximum 6 days blood is sampled at different time points and urine is collected during documented time intervals.

Hemodialysis patients on piperacillin-tazobactam

The antibiotic administration protocol is not changed for this study. From the first administration on, administrations (dosage and duration) are well documented. Blood samples are taken as peak, distribution and trough samples during at least 24 or 48 hours. During the first dialysis session after study start, blood samples are also taken from the arterial and venous blood line simultaneously and at different dialysis time points, to calculate dialyzer extraction ratio. When appropriate, urine is collected during a documented period. During the second dialysis after study start, arterial and venous samples are taken for different dialysis settings, in order to calculate extraction ratios for different settings.

All blood and urine samples are analyzed for piperacillin-tazobactam.

Blood and urine sampling

Intervention Type OTHER

During a period of maximum 6 days blood is sampled at different time points and urine is collected during documented time intervals.

Hemodialysis patients on vancomycin

The antibiotic administration protocol is not changed for this study. From the first administration on, administrations (dosage and duration) are well documented. Blood samples are taken as peak, distribution and trough samples during at least 24 or 48 hours. During the first dialysis session after study start, blood samples are also taken from the arterial and venous blood line simultaneously and at different dialysis time points, to calculate dialyzer extraction ratio. When appropriate, urine is collected during a documented period. During the second dialysis after study start, arterial and venous samples are taken for different dialysis settings, in order to calculate extraction ratios for different settings.

All blood and urine samples are analyzed for vancomycin.

Blood and urine sampling

Intervention Type OTHER

During a period of maximum 6 days blood is sampled at different time points and urine is collected during documented time intervals.

Hemodialysis patients on teicoplanin

The antibiotic administration protocol is not changed for this study. From the first administration on, administrations (dosage and duration) are well documented. Blood samples are taken as peak, distribution and trough samples during at least 24 or 48 hours. During the first dialysis session after study start, blood samples are also taken from the arterial and venous blood line simultaneously and at different dialysis time points, to calculate dialyzer extraction ratio. When appropriate, urine is collected during a documented period. During the second dialysis after study start, arterial and venous samples are taken for different dialysis settings, in order to calculate extraction ratios for different settings.

All blood and urine samples are analyzed for teicoplanin.

Blood and urine sampling

Intervention Type OTHER

During a period of maximum 6 days blood is sampled at different time points and urine is collected during documented time intervals.

Interventions

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Blood and urine sampling

During a period of maximum 6 days blood is sampled at different time points and urine is collected during documented time intervals.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* patients with end-stage kidney disease, requiring intermittent hemodialysis
* patient receiving antibiotic treatment for documented or presumed infection (vancomycin, teicoplanin, amoxicillin-clavulanic acid, piperacillin-tazobactam, ceftazidim)

Exclusion Criteria

* pregnant woman
* absence of written informed consent from the patient
* known hypersensitivity or contra-indication to glycopeptides or beta-lactam antibiotics
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Ghent

OTHER

Sponsor Role collaborator

University Hospital, Ghent

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Wim Van Biesen, PhD, MD

Role: STUDY_CHAIR

University Hospital, Ghent

Locations

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Ghent University Hospital

Ghent, , Belgium

Site Status

Countries

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Belgium

Other Identifiers

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UGent_ABdosing

Identifier Type: -

Identifier Source: org_study_id

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