Single- and multiple-dose pharmacokinetics of ethambutol (EMB) and rifampicin (RIF) in a patient requiring both ECMO and renal replacement therapy are reported for the first time.
Extended dialysis eliminates EMB effectively and to a larger extent than regular intermittent haemodialysis in outpatients.
Also RIF, previously reported to be non-dialysable, could be found in the spent dialysate.
There was no detectable effect of the ECMO membrane on the removal of both drugs.
We conclude that after an initial dose, as for patients without renal impairment (15 mg/kg/day), therapeutic drug monitoring should be used to guide EMB dosing in patients undergoing extended daily dialysis.