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Impact of hypoalbuminemia on clinical outcomes among patients with obesity treated with ceftriaxone.
Arensman Hannan, Kellie; Draper, Evan; Cole, Kristin C; Mc Hugh, Jack; Rivera, Christina G; Abu Saleh, Omar.
Afiliação
  • Arensman Hannan K; Department of Pharmacy, Mayo Clinic Health System, Mankato, Minnesota, USA.
  • Draper E; Department of Pharmacy, Mayo Clinic, Rochester, Minnesota, USA.
  • Cole KC; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA.
  • Mc Hugh J; Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA.
  • Rivera CG; Department of Pharmacy, Mayo Clinic, Rochester, Minnesota, USA.
  • Abu Saleh O; Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Antimicrob Agents Chemother ; 68(4): e0166323, 2024 Apr 03.
Article em En | MEDLINE | ID: mdl-38411988
ABSTRACT
The use of ceftriaxone, a highly protein-bound drug, in the setting of hypoalbuminemia may result in suboptimal drug exposure. Patients with obesity also exhibit higher absolute drug clearance. We aimed to evaluate the impact of hypoalbuminemia on clinical success among hospitalized adults with obesity who were treated with ceftriaxone. This retrospective review included adult inpatients with weight >100 kg or body mass index >40 kg/m2 who received ceftriaxone 2 g intravenously every 12 hours for at least 72 hours. The primary outcome was clinical success, a composite of clinical cure and microbiologic cure. Secondary outcomes included clinical cure, microbiologic cure, length of stay, ICU length of stay, mortality, 30-day readmission, and adverse events. In all, 137 patients were included, 34 of whom had a serum albumin of ≤2.5 g/dL. In a propensity-score-weighted analysis, clinical success was significantly more common among those without hypoalbuminemia (91.2%) as compared to those with hypoalbuminemia (77.8%) (P = 0.038). Death within 30 days (13.7% vs 0%, P < 0.001) and 30-day readmission (31.6% vs 12.0%, P = 0.008) were more common in the hypoalbuminemia group. In a univariate analysis, serum albumin and indication for ceftriaxone use were found to be predictors of clinical success. Hypoalbuminemia was associated with a lower rate of clinical success among patients with obesity who were treated with ceftriaxone 2 g every 12 hours.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Hipoalbuminemia Limite: Adult / Humans Idioma: En Revista: Antimicrob Agents Chemother Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Hipoalbuminemia Limite: Adult / Humans Idioma: En Revista: Antimicrob Agents Chemother Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos