Pharmacokinetics of vancomycin and meropenem during continuous online hemodiafiltration: A case report

•Online hemodiafiltration affects pharmacokinetics of vancomycin and meropenem.•Continuous online hemodiafiltration requires high doses of these antibiotics.•Therapeutic drug monitoring is useful under continuous online hemodiafiltration. The pharmacokinetics of vancomycin and meropenem in patients treated with continuous online hemodiafiltration (OL-HDF) are not well understood. We evaluated dialytic clearance and serum concentrations of vancomycin and meropenem by OL-HDF in a critically ill patient with soft tissue infection. The mean clearance of OL-HDF and mean serum concentrations during continuous OL-HDF were 155.2 mL/min and 23.1 µg/mL for vancomycin and 145.6 mL/min and 22.7 µg/mL for meropenem. Vancomycin and meropenem showed high clearance rates during continuous OL-HDF. However, continuous infusion of these agents at high doses maintained therapeutic serum concentrations.