WCK 5222 is a novel β-lactam–β-lactam-enhancer combination of cefepime (FEP) and zidebactam (ZID). ZID is a novel β-lactam enhancer with a dual action of binding to Gram-negative penicillin-binding protein 2 (PBP2) and β-lactamase inhibition. WCK 5222 is being developed as a new therapeutic option for the treatment of complicated multidrug-resistant Gram-negative pathogen infections. We investigated the effect of renal impairment on the pharmacokinetics (PK) and safety of WCK 5222 in 48 subjects based on Cockcroft-Gault-estimated creatinine clearance (CLCR). We enrolled mild (n = 6; CLCR, 60 to <90 ml/min), moderate (n = 6; CLCR, 30 to <60 ml/min), and severe (n = 6; CLCR, <30 ml/min; not on dialysis) impairment, end-stage renal disease (ESRD) on hemodialysis (HD) (n = 6), and matched normal controls (n = 24; CLCR, ≥90 ml/min). Healthy control subjects and mild and moderate renal impairment subjects received a single 60-min intravenous (i.v.) infusion of 3 g WCK 5222 (2 g FEP/1 g ZID); severe renal impairment and HD subjects received a single 60-min i.v. infusion of 1.5 g WCK 5222 (1 g FEP plus 0.5 g ZID). Body and renal clearance decreased, and plasma half-life (t1/2) and the area under the concentration-time curve from time zero extrapolated to infinity (AUC0–∞ [h µg/ml]) increased in a graded relationship with severity of renal impairment for both FEP and ZID. Our findings suggest that dose adjustments for WCK 5222 will be required according to the degree of renal impairment. Overall, WCK 5222 (FEP-ZID) was found to be safe and well tolerated in subjects with normal and impaired renal function. (This study has been registered at ClinicalTrials.gov under identifier NCT02942810.)
Aged care communities have been under the spotlight since the beginning of 2020. Energy is essential to ensure reliable operation and quality care provision in residential aged care communities (RAC). The aim of this study is to determine how RAC’s yearly energy use and peak demand changed in Australia and what this might mean for RAC design, operation and energy asset investment and ultimately in the healthcare plan for elderly residents. Five years of electricity demand data from four case study RACs in the same climate zone are analyzed. Statistical tools are used to analyze the data, and a clustering algorithm is used to identify typical demand profiles. A number of energy key performance indicators (KPIs) are evaluated, highlighting their respective benefits and limitations. The results show an average 8% reduction for yearly energy use and 7% reduction for yearly peak demands in the COVID-19 year compared with the average of the previous four years. Typical demand profiles for the four communities were mostly lower in the pandemic year. Despite these results, the KPI analysis shows that, for these four communities, outdoor ambient temperature remains a very significant correlation factor for energy use.
Communal living for older people exists in many different forms, such as suburban communities, lifestyle communities, retirement villages and residential aged care communities (RAC) where electricity is supplied via a main gate meter to the whole community. Australia’s Small-scale Renewable Energy Scheme incentivizes individuals and businesses to install renewable energy systems up to 100 kW peak. A system of this size, however, may not meet a community’s energy needs or sustainability goals. In contrast, other residential dwellings are allowed to install a minimum solar inverter of 5 kW. Therefore, this paper investigates small-scale renewable energy targets on a per bed basis for RACs and the impact of a change from the current 100 kWpeak small-scale renewable energy policy. A data driven clustering-based method has been implemented to identify financially optimal photovoltaic (PV) system ratings for ten RACs across four climate zones. Explored are 100 kWpeak PV and net zero electricity scenarios. Results show RACs with 5 kW PV per bed can move closer to a net zero electricity goal and generate 800 to 1400 GWh of renewable electricity each year with significant financial savings. A fairer renewable policy, based on kilowatts per bed, is advocated to improve communities’ energy resilience, financial sustainability, and environmental sustainability.
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