Optimizing beta-lactam pharmacodynamics against Pseudomonas aeruginosa in adult cystic fibrosis patients

R. Zachary Thompson, Craig A. Martin, Donna R. Burgess, W. Cliff Rutter, David S. Burgess

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Background: Patients with cystic fibrosis (CF) exhibit increased clearance of beta-lactams. The purpose of this study was to predict the probability of beta-lactam target attainment (PTA) against Pseudomonas aeruginosa in adult CF patients based on local microbiological data. Methods: CF-specific pharmacokinetic parameters were obtained from published data for aztreonam, cefepime, ceftazidime, meropenem and piperacillin-tazobactam. Pharmacodynamic modeling was used to determine the PTA for bolus, prolonged infusion, and continuous infusion regimens. Results: Prolonged infusion of meropenem 2. g every 8. h performed the best among all regimens tested, with a PTA of 83%. The PTA was increased with both prolonged and continuous infusion; however, no regimen reached the target PTA of >. 90% against P. aeruginosa in CF patients at our institution. Conclusions: Prolonged and continuous infusion provided higher PTA than bolus for all regimens. Further investigation of novel regimens in CF patients is needed.

Original languageEnglish (US)
JournalJournal of Cystic Fibrosis
DOIs
StateAccepted/In press - Nov 5 2015
Externally publishedYes

Keywords

  • Beta-lactam
  • Continuous-infusion
  • Pharmacodynamics
  • Pharmacokinetics
  • Prolonged infusion
  • Pseudomonas aeruginosa

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Pediatrics, Perinatology, and Child Health

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