Pharmacokinetics of sulfamethoxazole and trimethoprim during veno ‐venous extracorporeal membrane oxygenation: A case report

We describe a case of a 33‐year old male with severe respiratory failure due toPneumocystis jirovecii infection on a background of recently diagnosed HIV infection. He required veno ‐venous ECMO therapy for refractory respiratory failure. Intravenous sulfamethoxazole‐trimethoprim (100 mg/kg/day and 20 mg/kg/day) was administered in a 6‐hourly dosing regimen. Pre‐oxygenator, post‐oxygenator and arterial blood samples were collected post antibiotic administration and we re analyzed for total sulfamethoxazole and trimethoprim concentrations. The peak sulfamethoxazole and trimethoprim concentrations were 122 mg/L and 5.3 mg/L, respectively. The volume of distribution for sulfamethoxazole was 0.37 L/kg and 2.30 L/Kg for trimethoprim. The clearance for sulfamethoxazole was 0.35 ml/min/kg and for trimethoprim was 1.64 mL/min/kg. The pharmacokinetics of sulfamethoxazole and trimethoprim appear not to be affected by ECMO therapy and dosing adjustment may not be required.
Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy - Category: Drugs & Pharmacology Authors: Tags: CASE REPORT Source Type: research