Target attainment and pharmacokinetics of cefotaxime in critically ill patients undergoing continuous kidney replacement therapy.
J Antimicrob Chemother
; 77(12): 3421-3426, 2022 11 28.
Article
em En
| MEDLINE
| ID: mdl-36210582
ABSTRACT
OBJECTIVES:
Limited data exist about the antimicrobial target attainment and pharmacokinetics of cefotaxime in critically ill patients in the ICU undergoing continuous kidney replacement therapy (CKRT). We conducted a prospective observational study in two large teaching hospitals [Isala Hospital (IH) and Zwolle and Maasstad Hospital (MH)] to investigate target attainment and pharmacokinetics of cefotaxime in patients undergoing CKRT. PATIENTS ANDMETHODS:
Patients aged ≥18â years admitted to the ICU treated with IV cefotaxime 1000â mg three times daily (IH) or 4 times daily (MH) were included. Fifteen patients were enrolled in total. Per patient eight cefotaxime plasma and eight ultrafiltrate samples were drawn in IH and four plasma samples in MH on Day 2 of treatment. In ICU patients the recommended antimicrobial target of cefotaxime is a plasma concentration 100% of the time above the MIC.RESULTS:
In IH 10/11 patients had higher plasma trough concentrations than the MIC breakpoint of Enterobacterales of 1â mg/L (clinical breakpoint for susceptible strains) and 9/11 patients had concentrations above 2â mg/L (clinical breakpoint for resistant strains). All patients (4/4) in MH had higher plasma trough concentrations than 2â mg/L. A sieving coefficient of 0.74 was identified, with a median amount of 40% of cefotaxime eliminated by CKRT.CONCLUSIONS:
We conclude that cefotaxime 1000â mg 3-4 times daily gives adequate plasma concentrations in patients with anuria or oliguria undergoing CKRT. The 1000â mg four times daily dosage is recommended in patients undergoing CKRT with partially preserved renal function to achieve the target.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cefotaxima
/
Terapia de Substituição Renal Contínua
Tipo de estudo:
Observational_studies
Limite:
Adolescent
/
Adult
/
Humans
Idioma:
En
Revista:
J Antimicrob Chemother
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Holanda