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Cefepime Dosing Requirements in Elderly Patients Attended in the Emergency Rooms.
Ruiz-Ramos, Jesus; Herrera-Mateo, Sergio; López-Vinardell, Laia; Juanes-Borrego, Ana; Puig-Campmany, Mireia; Mangues-Bafalluy, Maria Antonia.
Afiliación
  • Ruiz-Ramos J; Pharmacy Department, Hospital Santa Creu I Sant Pau, Barcelona, Spain.
  • Herrera-Mateo S; Emergency Department, Hospital Santa Creu I Sant Pau, Barcelona, Spain.
  • López-Vinardell L; Pharmacy Department, Hospital Santa Creu I Sant Pau, Barcelona, Spain.
  • Juanes-Borrego A; Pharmacy Department, Hospital Santa Creu I Sant Pau, Barcelona, Spain.
  • Puig-Campmany M; Emergency Department, Hospital Santa Creu I Sant Pau, Barcelona, Spain.
  • Mangues-Bafalluy MA; Pharmacy Department, Hospital Santa Creu I Sant Pau, Barcelona, Spain.
Dose Response ; 20(1): 15593258221078393, 2022.
Article en En | MEDLINE | ID: mdl-35237115
OBJECTIVE: This study aimed to assess the probability of reaching an adequate pharmacokinetic/pharmacodynamic (pK/pD) index for different cefepime dosages in frail patients with bacteremia treated in the emergency room. METHODS: Simulation study based on Gram-negative bacterial strains that cause bacteremia. The probability of reaching a time above the minimum inhibitory concentration (MIC) at 50% and 100% dosing intervals (fT > 50 and fT > 80% MIC) was assessed for two different renal clearance intervals. RESULTS: One hundred twenty nine strains were collected, the predominant species being Escherichia coli (n = 83 [64.3%]). In patients with a ClCr of 30 mL/min, an fT > 50% MIC was reached in more than 90% of the simulations. However, a dose of at least 1 g every 12 h must be administered to reach an fT > 80% MIC. In patients with a ClCr of 30-60 mL/min, the probability of reaching an fT > 50% MIC was higher than 90% with doses of 1 g every 8 h or more, but this value was not reached in > 90% simulations for any of the doses tested in this study. CONCLUSIONS: Standard cefepime dosing can reach an adequate PK/PD index in frail patients. Nevertheless, a high dose or extended infusion is necessary to reach an fT > 80% MIC in patients with a ClCr > 60 mL/min.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Dose Response Año: 2022 Tipo del documento: Article País de afiliación: España Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Dose Response Año: 2022 Tipo del documento: Article País de afiliación: España Pais de publicación: Estados Unidos