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Cefepime continues infusion

Laura Whited, Meagan Grove, Dusten Rose, Nathaniel J Rhodes, Marc H Scheetz, J Nicholas O'Donnell, Jessica Neeb, Kelli Thoele, David R Jones, Christopher Lowe, Dawn Moore, Patrick J Kiel
STUDY OBJECTIVE: To evaluate the steady-state pharmacokinetic parameters of standard cefepime dosing regimens in a hematologic malignancy and hematopoietic cell transplant patient population with febrile neutropenia. DESIGN: Open-label, single-center, prospective pharmacokinetic study. SETTING: National Cancer Institute-designated cancer center. PATIENTS: Nine adults with hematologic malignancies or hematopoietic cell transplants who had febrile neutropenia and were admitted to a hematology-oncology service between January and July 2014...
September 2016: Pharmacotherapy
Naiane Roveda Marsilio, Daiandy da Silva, Denise Bueno
OBJECTIVES: This study sought to identify the physical and chemical incompatibilities among the drugs administered intravenously to patients admitted to an adult intensive care unit. We also aimed to establish pharmaceutical guidelines for administering incompatible drugs. METHODS: This cross-sectional, prospective, and quantitative study was conducted from July to September 2015. Drug incompatibilities were identified based on an analysis of the patient prescriptions available in the hospital online management system...
June 2016: Revista Brasileira de Terapia Intensiva
A Charmillon, E Novy, N Agrinier, M Leone, A Kimmoun, B Levy, B Demoré, J Dellamonica, C Pulcini
Our objective was to assess current practices about the administration (intermittent, extended, or continuous infusions) and therapeutic drug monitoring (TDM) of β-lactam antibiotics and vancomycin in France. We conducted a nationwide cross-sectional survey in May-August 2015, using an online questionnaire, sent as an e-mail link to infectious disease specialists and intensive care specialists through national mailing lists. We used clinical vignettes of critically ill patients to assess physicians' practices about administration and TDM practices for amoxicillin, cloxacillin, piperacillin/tazobactam, cefotaxime, ceftazidime, cefepime, meropenem and vancomycin...
July 2016: Clinical Microbiology and Infection
R Zachary Thompson, Craig A Martin, Donna R Burgess, W Cliff Rutter, David S Burgess
BACKGROUND: Patients with cystic fibrosis (CF) exhibit increased clearance of beta-lactams. The purpose of this study was to predict the probability of beta-lactam target attainment (PTA) against Pseudomonas aeruginosa in adult CF patients based on local microbiological data. METHODS: CF-specific pharmacokinetic parameters were obtained from published data for aztreonam, cefepime, ceftazidime, meropenem and piperacillin-tazobactam. Pharmacodynamic modeling was used to determine the PTA for bolus, prolonged infusion, and continuous infusion regimens...
September 2016: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
Sarah V Burgess, Vincent H Mabasa, Ivy Chow, Mary H H Ensom
OBJECTIVE: To perform a qualitative systematic review of the evidence comparing traditional with prolonged intermittent or continuous infusions of cefepime based on clinical and pharmacodynamic outcomes. DATA SOURCES: PubMed (1946 to October 2014), EMBASE (1980 to October 2014), CENTRAL, Cochrane Database of Systematic Reviews, Web of Science, and International Pharmaceutical Abstracts (1970 to October 2014) were searched using the terms cefepime, pharmacokinetics, pharmacodynamics, drug administration, intravenous infusions, intravenous drug administration, continuous infusion, extended infusion, and intermittent therapy...
March 2015: Annals of Pharmacotherapy
Andrew S Hunter, David J Guervil, Katherine K Perez, Amy N Schilling, Collin N Verheyden, Nancy N Vuong, Ran Xu
PURPOSE: The most important articles on infectious diseases (ID) pharmacotherapy published in the peer-reviewed literature in 2013, as nominated and selected by panels of pharmacists and others with ID expertise, are summarized. SUMMARY: Members of the Houston Infectious Diseases Network were asked to nominate articles published last year in prominent biomedical journals that had a major impact in the field of ID pharmacotherapy. A list of 27 nominated articles on ID-related topics in general and 26 articles specifically focused on human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS) was compiled...
November 15, 2014: American Journal of Health-system Pharmacy: AJHP
Huawei Huang, Shengyue Huang, Pengli Zhu, Xiuming Xi
Cefepime is administered as an intermittent infusion (II); however, continuous infusion (CI) may be advantageous because β-lactam antibiotics exhibit time-dependent antibacterial activity. This retrospective, non-randomised, comparative study included 68 neurosurgical patients with post-operative intracranial infections treated with 4g/day cefepime over 24h as a CI (n=34) or 2g every 12h as II (n=34). CI controlled the intracranial infection more rapidly and effectively than II (6.6±1.9 days vs. 7.8±2.6 days; P=0...
January 2014: International Journal of Antimicrobial Agents
Jeffery T Zobell, Christina Ferdinand, David C Young
Aztreonam, cefepime, and ceftazidime are anti-pseudomonal beta-lactam antibiotics which have been previously reported to be administered by continuous infusion (CI) in pediatric CF patients. We present two cases administering intravenous (IV) meropenem and ticarcillin-clavulanate by CI in pediatric CF patients. The delivery of beta-lactam antibiotics via CI should be considered in order to optimize the pharmacodynamics (PD) of beta-lactams in the treatment of acute pulmonary exacerbations (APE).
March 2014: Pediatric Pulmonology
Violeta Raverdy, Els Ampe, Jean-Daniel Hecq, Paul M Tulkens
BACKGROUND: Vancomycin is increasingly used by continuous infusion, but few specific data are available about stability under practical conditions of preparation and use, and compatibility with other intravenous drugs commonly used in the routine hospital setting. METHODS: Vancomycin stability [defined as recovery ≥ 93% of the original content (validated HPLC assay)] was examined throughout the whole process of centralized preparation, storage and use in the ward by infusion for up to 48 h, with allowances for deviations from recommended practice [exposure to high temperature; use of concentrated solutions (up to 83 g/L)]...
May 2013: Journal of Antimicrobial Chemotherapy
F M Buyle, J Decruyenaere, J De Waele, P M Tulkens, T Van Audenrode, P Depuydt, G Claeys, H Robays, D Vogelaers
Extended and continuous infusions with beta-lactam antibiotics have been suggested as a means of pharmacokinetic and pharmacodynamic optimisation of antimicrobial therapy. Vancomycin is also frequently administered in continuous infusion, although more for practical reasons. A survey was undertaken to investigate the recommendations by the local antibiotic management teams (AMTs) in Belgian acute hospitals concerning the administration (intermittent, extended or continuous infusion) and therapeutic drug monitoring of four beta-lactam antibiotics (ceftazidime, cefepime, piperacillin-tazobactam, meropenem) and vancomycin for adult patients with a normal kidney function...
June 2013: European Journal of Clinical Microbiology & Infectious Diseases
Mary Covington Walker, Weng Man Lam, Kalen B Manasco
OBJECTIVE: To conduct a systematic review of available data on the use of extended or continuous infusion of β-lactam and monobactam therapy in the pediatric population (aged 0-18 years). DATA SOURCES: A literature search was performed using PubMed (1975-May 2012), International Pharmaceutical Abstracts (1970-May 2012), and Web of Science (1977-May 2012) to identify studies for inclusion. In addition, reference citations from identified publications were reviewed...
November 2012: Annals of Pharmacotherapy
William A Prescott, Allison E Gentile, Jerod L Nagel, Rebecca S Pettit
OBJECTIVE: We sought to evaluate the pharmacokinetics, efficacy, safety, stability, pharmacoeconomics, and quality-of-life effects of continuous-infusion antipseudomonal beta-lactam therapy in patients with cystic fibrosis (CF). DATA SOURCES: Literature retrieval was accessed through Medline (from 1950 to December 2010) using the following terms: cystic fibrosis; beta-lactams or piperacillin or ticarcillin or cefepime or ceftazidime or doripenem or meropenem or imipenem/cilastin or aztreonam; continuous infusion or constant infusion; drug stability; economics, pharmaceutical; and quality of life...
November 2011: P & T: a Peer-reviewed Journal for Formulary Management
Susana Dimas Alvarez, Maria Del Carmen Fernandez Gonzalez Aragon, Alvaro Moreno, Francisca Palomares-Alonso, Helgi Jung Cook, Graciela Cardenas, Jose Luis Soto-Hernandez
OBJECTIVE: Cefepime neurotoxicity usually occurs in patients with renal impairment. The aim of this study was to evaluate the neurotoxicity of cefepime administered by continuous intravenous infusion during treatment of nosocomial infections in neurological patients with normal renal function. METHODS: This was an open pilot study of neurological patients with infections caused by cefepime sensitive bacteria. Patients had baseline neurological assessment and electroencephalogram (EEG)...
September 1, 2011: Central Nervous System Agents in Medicinal Chemistry
Joao Gonçalves-Pereira, Pedro Póvoa
INTRODUCTION: Several reports have shown marked heterogeneity of antibiotic pharmacokinetics (PK) in patients admitted to ICUs, which might potentially affect outcomes. Therefore, the pharmacodynamic (PD) parameter of the efficacy of β-lactam antibiotics, that is, the time that its concentration is above the bacteria minimal inhibitory concentration (T > MIC), cannot be safely extrapolated from data derived from the PK of healthy volunteers. METHODS: We performed a full review of published studies addressing the PK of intravenous β-lactam antibiotics given to infected ICU patients...
2011: Critical Care: the Official Journal of the Critical Care Forum
Takuya Iwamoto, Fumihiko Monma, Atsushi Fujieda, Kaname Nakatani, Naoyuki Katayama, Masahiro Okuda
BACKGROUND: A drug interaction between oral tacrolimus (TAC) and lansoprazole (LAN) has been reported in patients with CYP2C19 hetero/homozygous mutations and the CYP3A5 *3/*3 genotype. A PubMed search (implemented March 16, 2011) using search terms drug interaction, tacrolimus, and lansoprazole failed to identify drug interactions in CYP3A5 extensive metabolizers and parenterally administered TAC. OBJECTIVE: The purpose of this study was to report a case of drug interaction between intravenously administered TAC and LAN in a patient being treated with voriconazole (VCZ) and harboring CYP2C19 and CYP3A5 heterozygous mutations...
August 2011: Clinical Therapeutics
Lucie Seyler, Frédéric Cotton, Fabio Silvio Taccone, Daniel De Backer, Pascale Macours, Jean-Louis Vincent, Frédérique Jacobs
INTRODUCTION: Sepsis is responsible for important alterations in the pharmacokinetics of antibiotics. Continuous renal replacement therapy (CRRT), which is commonly used in septic patients, may further contribute to pharmacokinetic changes. Current recommendations for antibiotic doses during CRRT combine data obtained from heterogeneous patient populations in which different CRRT devices and techniques have been used. We studied whether these recommendations met optimal pharmacokinetic criteria for broad-spectrum antibiotic levels in septic shock patients undergoing CRRT...
2011: Critical Care: the Official Journal of the Critical Care Forum
Don Hayes, David J Feola, Brian S Murphy, Robert J Kuhn, George A Davis
PURPOSE: The use of a continuous infusion of a β-lactam antibiotic in combination with high-dose, extended-interval amino-glycoside therapy for eradication of Pseudomonas aeruginosa in an adult patient with cystic fibrosis (CF) is reported. SUMMARY: Testing of an expectorated sputum sample taken during routine evaluation of a 32-year-old woman with CF isolated P. aeruginosa; the patient's medical record indicated no prior episodes of P. aeruginosa colonization...
February 15, 2011: American Journal of Health-system Pharmacy: AJHP
Brad Moriyama, Stacey A Henning, Melinda M Neuhauser, Robert L Danner, Thomas J Walsh
OBJECTIVE: To describe the rationale, principles, and dosage calculations for continuous-infusion beta-lactam antibiotics to treat multidrug-resistant bacteria in patients undergoing continuous venovenous hemofiltration (CVVH). DATA SOURCES: A MEDLINE search (1968-November 2008) of the English-language literature was performed using the terms continuous infusion and Pseudomonas or Acinetobacter; hemofiltration or CVVH or hemodiafiltration or CVVHDF or continuous renal replacement therapy or pharmacokinetics; and terms describing different beta-lactam antibiotics...
July 2009: Annals of Pharmacotherapy
Joshua D Courter, Joseph L Kuti, Jennifer E Girotto, David P Nicolau
BACKGROUND: Administration of beta-lactams via prolonged or continuous infusion has been utilized in adults to optimize drug exposure and clinical outcomes. As children exhibit increased drug clearance, this may further the benefit of prolonged or continuous infusions. This dosing approach was applied to several beta-lactams commonly utilized in children. PROCEDURE: A variety of cefepime, ceftazidime, imipenem/cilastatin, meropenem, and piperacillin/tazobactam regimens using administration times of 0...
September 2009: Pediatric Blood & Cancer
H Elkhaïli, D Levêque, J D Peter, Y Salmon, J Salmon, D Pompei, H Monteil, F Jehl
The miniature pig is becoming a popular non-rodent animal model in biochemical research because of physiological similarities to humans. In addition, the micropig presents the advantages of large animal species for experimental pharmacokinetics. However, pharmacokinetics of antimicrobial agents are poorly documented in the pig and further work is needed to establish interspecies comparisons. This prompted us to investigate the disposition of three well documented beta-lactams (cefepime, cefpirome and meropenem) in this model and also to evaluate the potential to use it for pharmacodynamic studies...
March 1997: International Journal of Antimicrobial Agents
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