Christina König1,2, Stephan Braune2, Jason A Roberts3, Axel Nierhaus2, Oliver M Steinmetz4, Michael Baehr1, Otto R Frey5, Claudia Langebrake1,6, Stefan Kluge2. 1. Hospital Pharmacy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany. 2. Department of Intensive Care Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany. 3. Burns, Trauma, and Critical Care Research Centre and Centre for Translational Anti-infective Pharmacodynamics, The University of Queensland, Brisbane, Australia. 4. University Medical Center Hamburg-Eppendorf, Department of Internal Medicine III. (Nephrology/Rheumatology with Section Endocrinology), Hamburg, Germany. 5. Hospital Pharmacy, General Hospital of Heidenheim, Heidenheim, Germany. 6. Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Abstract
Objectives: To describe the population PKs of ceftazidime in critically ill patients receiving sustained low-efficiency dialysis (SLED). Patients and methods: This study was performed in ICUs of a university hospital. We collected blood samples during three consecutive days of SLED sessions in patients receiving ceftazidime. Concentration versus time curves were analysed using a population PKs approach with Pmetrics ® . Monte Carlo simulation for the first 24 h including a 6 h SLED session was performed with the final model. The fractional target attainment against the MIC of Pseudomonas aeruginosa was executed using targets of 50 and 100% fT > MIC . Results: In total, 211 blood samples of 16 critically ill patients under SLED were collected. SLED treatments were 299.3 (68.4) min in duration. A two-compartment linear population PK model was most appropriate. The mean (SD) CL of ceftazidime on SLED, and off SLED were 5.32 (3.2), 1.06 (1.0) L/h respectively. The PTA for 50% fT > MIC for a dose of 1 g intravenously every 8 h was 98%. Assuming a target of 100% fT > MIC a dose of 2 g every 12 h covers isolates with MIC ≤8 mg/L with a PTA of 96%. Conclusion: In critically ill patients receiving SLED, ceftazidime 1 g every 8 h and ceftazidime 2 g every 12 h appear to be sufficient for achieving traditional (50% fT > MIC ) and aggressive PD targets (100% fT > MIC ) for susceptible isolates (MIC ≤8 mg/L), respectively.
Objectives: To describe the population PKs of ceftazidime in critically illpatients receiving sustained low-efficiency dialysis (SLED). Patients and methods: This study was performed in ICUs of a university hospital. We collected blood samples during three consecutive days of SLED sessions in patients receiving ceftazidime. Concentration versus time curves were analysed using a population PKs approach with Pmetrics ® . Monte Carlo simulation for the first 24 h including a 6 h SLED session was performed with the final model. The fractional target attainment against the MIC of Pseudomonas aeruginosa was executed using targets of 50 and 100% fT > MIC . Results: In total, 211 blood samples of 16 critically illpatients under SLED were collected. SLED treatments were 299.3 (68.4) min in duration. A two-compartment linear population PK model was most appropriate. The mean (SD) CL of ceftazidime on SLED, and off SLED were 5.32 (3.2), 1.06 (1.0) L/h respectively. The PTA for 50% fT > MIC for a dose of 1 g intravenously every 8 h was 98%. Assuming a target of 100% fT > MIC a dose of 2 g every 12 h covers isolates with MIC ≤8 mg/L with a PTA of 96%. Conclusion: In critically illpatients receiving SLED, ceftazidime 1 g every 8 h and ceftazidime 2 g every 12 h appear to be sufficient for achieving traditional (50% fT > MIC ) and aggressive PD targets (100% fT > MIC ) for susceptible isolates (MIC ≤8 mg/L), respectively.
Authors: A Brinkmann; A C Röhr; A Köberer; T Fuchs; W A Krüger; C König; D Richter; M A Weigand; O R Frey Journal: Anaesthesist Date: 2018-06 Impact factor: 1.041
Authors: Sidharth Kumar Sethi; Vinod Krishnappa; Nisha Nangethu; Paul Nemer; Lawrence A Frazee; Rupesh Raina Journal: Can J Kidney Health Dis Date: 2018-08-10
Authors: Julia Zimmer; Anka C Röhr; Stefan Kluge; Jonas Faller; Otto R Frey; Dominic Wichmann; Christina König Journal: Antibiotics (Basel) Date: 2021-02-28
Authors: E Wallenburg; R J Brüggemann; K Asouit; M Teulen; A F J de Haan; E J F Franssen; R E Aarnoutse Journal: J Antimicrob Chemother Date: 2021-01-19 Impact factor: 5.790