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Temocillin dosage adjustment in a preterm infant with severe renal disease: a case report.
Dumangin, Guillaume; Brenkman, Matthieu; Pape, Elise; Kolodziej, Allan; Gambier, Nicolas; Vrillon, Isabelle; Charmillon, Alexandre; Scala-Bertola, Julien.
Afiliação
  • Dumangin G; Université de Lorraine, CHRU-Nancy, Department of Clinical Pharmacology and Toxicology, F-54000 Nancy, France.
  • Brenkman M; Université de Lorraine, CHRU-Nancy, Department of Clinical Pharmacology and Toxicology, F-54000 Nancy, France.
  • Pape E; Université de Lorraine, CHRU-Nancy, Department of Clinical Pharmacology and Toxicology, F-54000 Nancy, France.
  • Kolodziej A; Université de Lorraine, CNRS, IMoPA, F-54000 Nancy, France.
  • Gambier N; Université de Lorraine, CHRU-Nancy, Department of Clinical Pharmacology and Toxicology, F-54000 Nancy, France.
  • Vrillon I; Université de Lorraine, CHRU-Nancy, Department of Clinical Pharmacology and Toxicology, F-54000 Nancy, France.
  • Charmillon A; Université de Lorraine, CNRS, IMoPA, F-54000 Nancy, France.
  • Scala-Bertola J; CHRU-Nancy, Department of Pediatric Nephrology, F-54000 Nancy, France.
J Antimicrob Chemother ; 75(12): 3652-3655, 2020 12 01.
Article em En | MEDLINE | ID: mdl-32814946
BACKGROUND: Temocillin is a carboxypenicillin antibiotic indicated in complicated urinary tract infections due to susceptible ESBL-producing Enterobacteriaceae. While temocillin therapeutic schemes for adult patients with normal or impaired renal function are evidence based, little is known in paediatric populations. OBJECTIVES: We report herein the management of temocillin treatment in a preterm infant with end-stage renal disease. PATIENTS AND METHODS: The patient was a 7-month-old preterm infant born at 35 weeks gestation and treated by temocillin for 10 days for a bacteraemic urinary tract infection due to a susceptible ESBL-producing Enterobacter cloacae complex strain. Temocillin was administered by continuous infusion using a loading dose of 25 mg followed by a maintenance dose of 70 mg daily. Determination of MIC and temocillin plasma and urinary concentration was performed. RESULTS: Clinical improvement was observed 24 h after the initiation of temocillin treatment. Temocillin concentrations ranged between 21.6 and 35.5 mg/L in urine between the first and the sixth day of treatment and between 47.0 and 61.8 mg/L in plasma after 6 and 10 days of treatment, respectively. Temocillin concentrations were found to be above the determined MIC of 6 mg/L. From the measured concentrations, we can postulate that 100%fT>MIC was achieved in urine and at least equal to 40% in plasma. CONCLUSIONS: Temocillin dosing adjustment performed in the present reported case allowed safe and effective treatment. The strategy described herein could be used as a basis for further clinical studies relative to temocillin use in a paediatric population with renal impairment.
Assuntos

Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Penicilinas / Recém-Nascido Prematuro Limite: Humans / Infant Idioma: En Revista: J Antimicrob Chemother Ano de publicação: 2020 Tipo de documento: Article País de afiliação: França

Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Penicilinas / Recém-Nascido Prematuro Limite: Humans / Infant Idioma: En Revista: J Antimicrob Chemother Ano de publicação: 2020 Tipo de documento: Article País de afiliação: França