Dalbavancin Pharmacokinetics in an 18-Month-Old Child Undergoing Extracorporeal Membrane Oxygenation: A Short Communication

Background:Extracorporeal membrane oxygenation (ECMO) is a life-saving support for patients with severe respiratory or cardiac failure. During ECMO support, the pharmacokinetics of drugs is often affected. Therapeutic drug monitoring of antimicrobial agents ensures drug concentrations remain within the therapeutic range of the pharmacokinetic/pharmacodynamic (PK/PD) target.Methods:In this study, we describe the pharmacokinetic profile of dalbavancin in an 18-month-old child during ECMO and after ECMO discontinuation.Results:The noncompartmental analysis revealed a notable impact of ECMO on dalbavancin clearance, estimated to be 2.13 times higher during ECMO than after ECMO discontinuation and accounting for a reduction of 52.32% in terminal half-life (79.13 vs 165.98 hours).Conclusions:This pharmacokinetic alteration in dalbavancin disposition during ECMO may lead to suboptimal drug exposure, possibly impairing the ability to maintain PK/PD efficacy of dalbavancin over time.