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J. Antimicrob. Chemother. · May 2017
Observational StudyPopulation pharmacokinetics and dosing simulations of ceftazidime in critically ill patients receiving sustained low-efficiency dialysis.
- Christina König, Stephan Braune, Jason A Roberts, Axel Nierhaus, Oliver M Steinmetz, Michael Baehr, Otto R Frey, Claudia Langebrake, and Stefan Kluge.
- Hospital Pharmacy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
- J. Antimicrob. Chemother. 2017 May 1; 72 (5): 1433-1440.
ObjectivesTo describe the population PKs of ceftazidime in critically ill patients receiving sustained low-efficiency dialysis (SLED).Patients And MethodsThis 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 .ResultsIn 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%.ConclusionIn 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.© The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
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