In vitro effects of anti-MRSA agent adsorption onto the AN69ST hemofilter

Abstract

BackgroundBlood purification therapy with a sulfonated polyacrylonitrile surface treated (AN69ST) hemofilter is used to treat sepsis. However, the AN69ST hemofilter has been reported to adsorb and remove therapeutic drugs; warranting further investigation. In this study, we evaluated the adsorption effects of AN69ST membranes and hemofilters connected to a dialysis circuit model on anti-methicillin-resistant Staphylococcus aureus (anti-MRSA) agents, such as arbekacin sulfate (ABK), linezolid (LZD), vancomycin hydrochloride (VCM), teicoplanin (TEIC), and daptomycin (DAP), in in vitro experiments.MethodsDrug solutions were exposed to AN69ST membranes. The absorbance of the drug solution was measured over time, and the drug content was calculated. Additionally, we calculated the drug content over time by circulating the drug solution through a dialysis circuit model. The clearance of each drug was determined at 5 and 60 min.ResultsThe content of ABK, TEIC, DAP, and VCM decreased substantially after the addition of AN69ST membranes compared to those of the standard reagent. However, the LZD content did not decrease. In the dialysis circuit model, the content of ABK, TEIC, DAP, and VCM were 3.7%, 25.7%, 43.8%, and 44.5%, respectively, at 20 min, which were clearly lower than those of the standard reagent (62–64%). However, the LZD content remained unchanged. The clearance of ABK, TEIC, DAP, and VCM increased after 5 min.ConclusionsThe in vitro adsorption of anti-MRSA agents onto the AN69ST hemofilter was confirmed for ABK, TEIC, DAP, and VCM. Positively charged ABK was particularly susceptible to adsorption and should be avoided during blood purification using the AN69ST hemofilter. In addition, we concluded that TEIC, DAP, and VCM should be used for therapeutic drug monitoring because the adsorption rate of each drug is believed to vary depending on its protein binding rate.