Finding the dose for ceftolozane-tazobactam in critically ill children with and without acute kidney injury

Mostra el registre complet Registre parcial de l'ítem

  • dc.contributor.author Butragueño-Laiseca, Laura
  • dc.contributor.author Troconiz, Iñaki F.
  • dc.contributor.author Grau Cerrato, Santiago
  • dc.contributor.author Campillo Ambrós, Núria
  • dc.contributor.author García, Xandra
  • dc.contributor.author Padilla, Belén
  • dc.contributor.author Fernández, Sarah Nicole
  • dc.contributor.author Santiago, María José
  • dc.date.accessioned 2021-02-19T08:00:01Z
  • dc.date.available 2021-02-19T08:00:01Z
  • dc.date.issued 2020
  • dc.description.abstract Background: Ceftolozane-tazobactam is a new antibiotic against multidrug-resistant pathogens such as Pseudomonas aeruginosas. Ceftolozane-tazobactam dosage is still uncertain in children, especially in those with renal impairment or undergoing continuous renal replacement therapy (CRRT). Methods: Evaluation of different ceftolozane-tazobactam dosing regimens in three critically ill children. Ceftolozane pharmacokinetics (PK) were characterized by obtaining the patient's specific parameters by Bayesian estimation based on a population PK model. The clearance (CL) in patient C undergoing CRRT was estimated using the prefilter, postfilter, and ultrafiltrate concentrations simultaneously. Variables such as blood, dialysate, replacement, and ultrafiltrate flow rates, and hematocrit were integrated in the model. All PK analyses were performed using NONMEM v.7.4. Results: Patient A (8 months of age, 8.7 kg) with normal renal function received 40 mg/kg every 6 h: renal clearance (CLR) was 0.88 L/h; volume of distribution (Vd) Vd1 = 3.45 L, Vd2 = 0.942 L; terminal halflife (t1/2,β) = 3.51 h, dosing interval area under the drug concentration vs. time curve at steady-state (AUCτ,SS) 397.73 mg × h × L-1. Patient B (19 months of age, 11 kg) with eGFR of 22 mL/min/1.73 m2 received 36 mg/kg every 8 h: CLR = 0.27 L/h; Vd1 = 1.13 L; Vd2 = 1.36; t1/2,β = 6.62 h; AUCSS 1481.48 mg × h × L-1. Patient C (9 months of age, 5.8 kg), with severe renal impairment undergoing CRRT received 30 mg/kg every 8 h: renal replacement therapy clearance (CLRRT) 0.39 L/h; Vd1 = 0.74 L; Vd2= 1.17; t 1/2,β = 3.51 h; AUCτ,SS 448.72 mg × h × L-1. No adverse effects attributable to antibiotic treatment were observed. Conclusions: Our results suggest that a dose of 35 mg/kg every 8 h can be appropriate in critically ill septic children with multi-drug resistance Pseudomonas aeruginosa infections. A lower dose of 10 mg/kg every 8 h could be considered for children with severe AKI. For patients with CRRT and a high effluent rate, a dose of 30 mg/kg every 8 h can be considered.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Butragueño-Laiseca L, Troconiz IF, Grau S, Campillo N, García X, Padilla B. et al. Finding the dose for ceftolozane-tazobactam in critically ill children with and without acute kidney injury. Antibiotics (Basel). 2020 Dec 10; 9(12): 887. DOI: 10.3390/antibiotics9120887
  • dc.identifier.doi http://dx.doi.org/10.3390/antibiotics9120887
  • dc.identifier.issn 2079-6382
  • dc.identifier.uri http://hdl.handle.net/10230/46540
  • dc.language.iso eng
  • dc.publisher MDPI
  • dc.rights Copyright © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by/4.0/
  • dc.subject.keyword Acute kidney injury
  • dc.subject.keyword Ceftolozane
  • dc.subject.keyword Continuous renal replacement therapy
  • dc.subject.keyword Critically ill children
  • dc.subject.keyword Dose individualization
  • dc.subject.keyword Population pharmacokinetics
  • dc.title Finding the dose for ceftolozane-tazobactam in critically ill children with and without acute kidney injury
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

Col·leccions

Articles (Hospital del Mar Research Institute)