Impact of therapeutic plasma exchange on meropenem pharmacokinetics

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Abstract
Study Objective: The aim of this study was to investigate the impact of therapeutic plasma exchange (TPE) on the plasma concentrations and pharmacokinetic (PK) patterns of meropenem.Design: Prospective, open‐label, PK study.Setting: Academic tertiary care medical center.Patients: Eleven patients who underwent TPE.Measurements: A single‐center PK study was conducted on adult patients who underwent TPE. All patients received two phases of meropenem administration for research purposes. Meropenem PK studies were carried out after the administration of a single dose of 1 g of meropenem in the patients during TPE (phase 1) and compared with meropenem 1 g administration in the same patients without TPE (phase 2), which served as the control phase with an at least 72‐h wash‐out period separating the phases.Main Results: The total clearance (CL) of meropenem during TPE was greater than the values obtained from the same patients without TPE (13.37 ± 6.23 L/h during TPE vs. 8.42 ± 2.84 L/h without TPE). The mean drug fraction eliminated during TPE was 14.22 ± 11.03%, and the mean amount of drug removed by the TPE was 142.23 ± 110.31 mg.Conclusions: These results indicate that the TPE had an impact on the elimination of meropenem in patients during the exchange procedure. The CL of meropenem during TPE was greater than the values obtained from the control phase without TPE.

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