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 journalArticlepeer-review

    7 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)
    Pages (from-to)660-663
    Number of pages4
    JournalJournal of Cystic Fibrosis
    Volume15
    Issue number5
    DOIs
    StatePublished - Sep 1 2016

    Keywords

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

    ASJC Scopus subject areas

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

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