{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T20:11:19Z","timestamp":1784146279552,"version":"3.55.0"},"reference-count":28,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,8,31]],"date-time":"2023-08-31T00:00:00Z","timestamp":1693440000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background: Extracorporeal therapies (ET) are increasingly used in pediatric settings as adjuvant therapeutic strategies for overwhelming inflammatory conditions. Although these treatments seem to be effective for removing inflammatory mediators, their influence on antimicrobials pharmacokinetic should not be neglected. Methods: A prospective observational study of children admitted to the pediatric intensive care unit (PICU) with a diagnosis of sepsis\/septic shock. All critically ill children received hemoadsorption treatment with CytoSorb (CS) in combination with CKRT. Therapeutic drug monitoring has been performed on 10 critically ill children, testing four antimicrobial molecules: meropenem, ceftazidime, amikacin and levofloxacin. In order to evaluate the total and isolated CKRT and CS contributions to antibiotic removal, blood samples at each circuit point (post-hemofilter, post-CS and in the effluent line) were performed. Therefore, the clearance and mass Removal (MR) of the hemofilter and CS were calculated. Results: Our preliminary report describes a different impact of CS on these target drugs removal: CS clearance was low for amikacine (6\u201312%), moderate for ceftazidime (43%) and moderate to high for levofloxacine (52\u201372%). Higher MR and clearance were observed with CKRT compared to CS. To the best of our knowledge, this is the first report regarding pharmacokinetic dynamics in critically ill children treated with CKRT and CS for septic shock.<\/jats:p>","DOI":"10.3390\/antibiotics12091395","type":"journal-article","created":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T08:19:39Z","timestamp":1693556379000},"page":"1395","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Impact of Continuous Kidney Replacement Therapy and Hemoadsorption with CytoSorb on Antimicrobial Drug Removal in Critically Ill Children with Septic Shock: A Single-Center Prospective Study on a Pediatric Cohort"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2723-9914","authenticated-orcid":false,"given":"Gabriella","family":"Bottari","sequence":"first","affiliation":[{"name":"Pediatric Intensive Care Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bianca Maria","family":"Goffredo","sequence":"additional","affiliation":[{"name":"Division of Metabolic Diseases and Drug Biology, Bambino Ges\u00f9 Children\u2019s Hospital, IRCSS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7413-3194","authenticated-orcid":false,"given":"Marco","family":"Marano","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Maccarrone","sequence":"additional","affiliation":[{"name":"Anesthesia and Intensive Care Department of Human Pathology, University of Messina, 98158 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3989-7703","authenticated-orcid":false,"given":"Raffaele","family":"Simeoli","sequence":"additional","affiliation":[{"name":"Division of Metabolic Diseases and Drug Biology, Bambino Ges\u00f9 Children\u2019s Hospital, IRCSS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Bianco","sequence":"additional","affiliation":[{"name":"Hospital Pharmacy Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Vallesi","sequence":"additional","affiliation":[{"name":"Hospital Pharmacy Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph Charles Charlie","family":"Beetham","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Teresa","family":"Mazzeo","sequence":"additional","affiliation":[{"name":"Anesthesia and Intensive Care Department of Human Pathology, University of Messina, 98158 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Cappoli","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Dialysis, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5925-0974","authenticated-orcid":false,"given":"Sara","family":"Cairoli","sequence":"additional","affiliation":[{"name":"Division of Metabolic Diseases and Drug Biology, Bambino Ges\u00f9 Children\u2019s Hospital, IRCSS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaella","family":"Labbadia","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Dialysis, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corrado","family":"Cecchetti","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Bernaschi","sequence":"additional","affiliation":[{"name":"Microbiology and Diagnostic Immunology Unit, Department of Diagnostic and Laboratory Medicine, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiziana","family":"Corsetti","sequence":"additional","affiliation":[{"name":"Hospital Pharmacy Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4897-1602","authenticated-orcid":false,"given":"Santo","family":"Morabito","sequence":"additional","affiliation":[{"name":"Hemodialysis Unit, Department of Internal Medicine and Medical Specialties, Policlinico Umberto I, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio Silvio","family":"Taccone","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Hopital Universitaire de Bruxelles (HUB), Universit\u00e9 Libre de Bruxelles (ULB), 1050 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Guzzo","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Dialysis, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1001\/jama.2017.10108","article-title":"Extracorporeal organ support: From technological tool to clinical strategy supporting severe organ failure","volume":"318","author":"Ranieri","year":"2017","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e00583-19","DOI":"10.1128\/AAC.00583-19","article-title":"A guide to under standing antimicrobial drug dosing in critically ill patients on renal replacement therapy","volume":"63","author":"Pistolesi","year":"2019","journal-title":"Antimicrob. 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