EFFECTS OF CARDIOPULMONARY BYPASS ON TEICOPLANIN SERUM DISPOSITION

The time course oi teicoplanin (T) serum concentrations was determined in 6 patients who had undergone cardiopulmonary bypass (CPB). The dru g was given i.v. (12 mg/kg) 85-140 min before starting CPB. Serum conc entrations of T were measured with an automated fluorescence polarizat ion immunoassay, at appropriate times before, during and after CPB (to tal sampling interval. 12 h). Five min after initiating CPB, T serum c oncentrations decreased, on average, by 29% and remained less than the expected values (values extrapolated from the decay curve, measured e xcluding the CPB period) over the subsequent 60 min. When CPB was disc ontinued, the T serum concentrations rebounded to the expected values within 5 min. The mean area under the curve (AUC) during CPB was signi ficantly lower than the mean extrapolated AUC. It was concluded that C PB reversibly reduced T serum concentrations, probably due to drug red istribution. Nevertheless, T serum levels were always above the mean i nhibitory concentration (MIC) oi the most common pathogenic organisms associated with CPB surgery infections.