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Intensive Care Medicine

, Volume 32, Issue 12, pp 2059–2062 | Cite as

Pharmacokinetics and lung concentrations of ertapenem in patients with ventilator-associated pneumonia

  • Emmanuel BoselliEmail author
  • Dominique Breilh
  • Marie-Claude Saux
  • Jean-Baptiste Gordien
  • Bernard Allaouchiche
Brief Report

Abstract

Objective

We conducted a prospective, open-label study to determine the steady-state serum and epithelial lining fluid (ELF) concentrations of unbound ertapenem administered once daily to critically ill patients with early-onset ventilator-associated pneumonia (VAP).

Design and setting

Prospective, open-label study in an intensive care unit and research ward in a university hospital.

Patients

Fifteen patients with VAP received 1-h intravenous infusions of 1 g ertapenem once daily.

Interventions

After 2 days of therapy the steady-state serum and ELF concentrations of free ertapenem were determined by high-performance liquid chromatography.

Measurements and results

The median (interquartile range) free ertapenem peak (Cmax), intermediate (C12), and trough (Cmin) concentrations (mg/l) 1, 12, and 24 h after the end of infusion were 30.3 (27.1–37.8), 4.8 (3.9–6.4), and 0.8 (0.5–1.2) in serum and 9.4 (8.0–10.7), 2.0 (1.1–2.5), and 0.3 (0.2–0.4) in ELF, respectively, showing a median free ertapenem percentage penetration in ELF of approx. 30%. The median (interquartile range) serum area under concentration-time curve of free ertapenem during the observational period was 226.7 mg h−1 l−1 (202.2–263.9).

Conclusion

Our study shows satisfactory results, with unbound ertapenem concentrations both in serum and ELF exceeding the MIC90 values of most of the causative pathogens encountered in early-onset VAP during 50–100% time. This suggests that 1 g intravenous ertapenem administered once daily should be effective during the treatment of early-onset VAP in critically ill patients with no known risk factors for multidrug-resistant pathogens.

Keywords

Ertapenem Pharmacokinetics Lung diffusion Intensive care Early-onset Ventilator-associated pneumonia 

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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Emmanuel Boselli
    • 1
    Email author
  • Dominique Breilh
    • 2
  • Marie-Claude Saux
    • 2
  • Jean-Baptiste Gordien
    • 2
  • Bernard Allaouchiche
    • 1
  1. 1.Claude Bernard UniversityLyon cedex 08France
  2. 2.Clinical Pharmacokinetics LaboratoryHaut-Lévêque hospitalPessacFrance

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