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Cefepime continues infusion

Soo Min Jang, Katherine N Gharibian, Susan J Lewis, William H Fissell, Ashita J Tolwani, Bruce A Mueller
Cefepime, ceftazidime, and piperacillin/tazobactam are commonly used beta-lactam antibiotics in the critical care setting. For critically ill patients receiving prolonged intermittent renal replacement therapy (PIRRT), limited pharmacokinetic data are available to inform clinicians on the dosing of these agents. Monte Carlo simulations (MCS) can be used to guide drug dosing when pharmacokinetic trials are not feasible. For each antibiotic, MCS using previously published pharmacokinetic data derived from critically ill patients was used to evaluate multiple dosing regimens in 4 different prolonged intermittent renal replacement therapy effluent rates and prolonged intermittent renal replacement therapy duration combinations (4 L/h × 10 hours or 5 L/h × 8 hours in hemodialysis and hemofiltration modes)...
May 10, 2018: Journal of Clinical Pharmacology
Amar H Kelkar, Kavitha S Jacob, Eman B Yousif, John J Farrell
RATIONALE: Herein, we present a case of seemingly unprovoked portal vein thrombosis (PVT) occurring in the context of an acute cytomegalovirus (CMV) infection and prolonged debilitating fatigue. PATIENT CONCERNS: A 46-year-old male airline pilot presented with a 2 week history of abdominal pain, nausea, vomiting, watery diarrhea, and daily recurrent fevers. This was in the context of progressive, debilitating fatigue for 3 months forcing the patient to leave his job...
December 2017: Medicine (Baltimore)
Nathaniel J Rhodes, Meagan E Grove, Patrick J Kiel, J Nicholas O'Donnell, Laura K Whited, Dusten T Rose, David R Jones, Marc H Scheetz
Alterations in cefepime pharmacokinetic (PK) exposure and decreased bacterial susceptibility increase the risk of treatment failure. The impact of susceptible-dose-dependent (SDD) minimum inhibitory concentrations (MICs), i.e. 4-8 µg/mL, on target attainment rates for cefepime in febrile neutropenia (FN) is unclear. We sought to identify optimal cefepime regimens against SDD cefepime MICs in FN using a modelling and simulation approach. Creatinine clearance (CLCr ) and body surface area (BSA) covariate-adjusted models of clearance were evaluated...
September 2017: International Journal of Antimicrobial Agents
Jeffrey J Cies, Wayne S Moore, Susan B Conley, Paul Shea, Adela Enache, Arun Chopra
An 11-year-old African American male with severe combined immunodeficiency variant, non-cystic fibrosis bronchiectasis, pancreatic insufficiency, chronic mycobacterium avium-intracellulare infection, chronic sinusitis, and malnutrition presented with a 1-week history of fevers. He subsequently developed respiratory decompensation and cefepime was discontinued and doripenem was initiated. Doripenem was the carbapenem used due to a national shortage of meropenem. By day 7 the patient (24.7 kg) had a positive fluid balance of 6925 mL (28% FO), and on days 7 into 8 developed acute kidney injury evidenced by an elevated serum creatinine of 0...
January 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Jaime A Foushee, Pmichaele Meredith, Laura M Fox, EdwardE Grace
Parenteral beta-blocker therapy via continuous infusion has shown promising results for improved outcomes for patients with septic shock. As patients with septic shock may require multiple intravenous medications, compatibility is necessary to co-infuse these medications through a y-site connector. The purpose of this study was to examine the physical compatibility of select intravenous drugs used for patients with septic shock combined with various intravenous beta-blockers including esmolol, labetalol, and metoprolol through a simulated y-site infusion...
July 2016: International Journal of Pharmaceutical Compounding
Raül Rigo-Bonnin, Alba Ribera, Ariadna Arbiol-Roca, Sara Cobo-Sacristán, Ariadna Padullés, Òscar Murillo, Evelyn Shaw, Rosa Granada, Xosé L Pérez-Fernández, Fe Tubau, Pedro Alía
BACKGROUND: The administration of β-lactam antibiotics in continuous infusion could let optimize the pharmacokinetic/pharmacodynamic parameters, especially in the treatment of serious bacterial infections. In this context, and also due to variability in their plasmatic concentrations, therapeutic drug monitoring (TDM) may be useful to optimize dosing and, therefore, be useful for the clinicians. MATERIAL AND METHODS: We developed and validated a measurement procedure based on ultra-high performance liquid chromatography-tandem mass spectrometry for simultaneous measurement of amoxicillin, ampicillin, cloxacillin, piperacillin, cefepime, ceftazidime, cefuroxime, aztreonam and meropenem concentrations in plasma...
May 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
T Huwyler, L Lenggenhager, M Abbas, K Ing Lorenzini, S Hughes, B Huttner, A Karmime, I Uçkay, E von Dach, P Lescuyer, S Harbarth, A Huttner
OBJECTIVES: Cefepime remains an important antibiotic for severe bacterial infections, yet some meta-analyses have shown elevated mortality among patients randomized to it. Therapeutic drug monitoring (TDM) of β-lactam antibiotics is increasing, but optimal plasma concentrations remain unknown. We examined clinical outcomes of patients undergoing cefepime TDM in an initial effort to define the drug's toxicity threshold. METHODS: In this single-centre retrospective cohort study, we enrolled all adult hospitalized patients receiving cefepime and undergoing TDM from January 2013 through July 2016...
July 2017: Clinical Microbiology and Infection
Wayne Moore, Arun Chopra, Jeffrey Cies
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
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
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