Continuous Infusion of Ceftazidime in Cystic Fibrosis

Kuzemko, J A; Crawford, Cynda

doi:10.1016/s0140-6736(89)90561-8

Cited by 35 publications

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“…Daily doses of up to 12 g ceftazidime split into 3 or 4 intermittent doses have been recommended for CF patients (24), whereas other authors recommend lower daily doses of 6 g in adult CF patients (30). To increase the PK-PD MIC breakpoints and clinical outcome, continuous infusion of ceftazidime has been proposed and studied in CF patients (8,13,23,36,42,59,(74)(75)(76).…”

Section: Discussionmentioning

confidence: 99%

Population Pharmacokinetic Comparison and Pharmacodynamic Breakpoints of Ceftazidime in Cystic Fibrosis Patients and Healthy Volunteers

Bulitta

Landersdorfer

Hüttner

et al. 2010

Antimicrob Agents Chemother

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Despite the promising activity of ceftazidime against Pseudomonas aeruginosa and Burkholderia cepacia, there has not yet been a study that directly compared the pharmacokinetics (PK) of ceftazidime in cystic fibrosis (CF) patients and healthy volunteers by population PK methodology. We assessed the population PK and PK/pharmacodynamic (PD) breakpoints of ceftazidime in CF patients and healthy volunteers.

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Section: Discussionmentioning

confidence: 99%

Population Pharmacokinetic Comparison and Pharmacodynamic Breakpoints of Ceftazidime in Cystic Fibrosis Patients and Healthy Volunteers

Bulitta

Landersdorfer

Hüttner

et al. 2010

Antimicrob Agents Chemother

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“…Previous clinical studies concluded that the CI of ceftazidime was effective in patients with CF, but only very small numbers of patients were studied. Moreover, in some of those studies, ceftazidime was administered as monotherapy and CI was not compared with SIs (13,33). In the study by Vinks et al (33), 17 adult patients with CF received 33 courses of treatment by the CI of ceftazidime at a dose of 100 mg/kg/day for acute exacerbation of lung infection over a period of 2 years.…”

Section: Discussionmentioning

confidence: 99%

Continuous versus Intermittent Infusions of Ceftazidime for Treating Exacerbation of Cystic Fibrosis

Hubert

Roux

Lavrut

et al. 2009

Antimicrob Agents Chemother

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The present multicenter, randomized crossover study compared the safety and efficacy of continuous infusion with those of short infusions of ceftazidime in patients with cystic fibrosis. Patients with chronic Pseudomonas aeruginosa colonization received two successive courses of intravenous tobramycin and ceftazidime (200 mg/kg of body weight/day) for pulmonary exacerbation administered as thrice-daily short infusions or as a continuous infusion. The primary endpoint was the variation in the forced expiratory volume in 1 s (FEV 1 ) during the course of antibiotic treatment. Sixty-nine of the 70 patients enrolled in the study received at least one course of antibiotic treatment. The improvement in FEV 1 at the end of therapy was not statistically different between the two treatment procedures (؉7.6% after continuous infusion and ؉5.5% after short infusions) but was better after continuous ceftazidime treatment in patients harboring resistant isolates (P < 0.05). The interval between the course of antibiotic treatments was longer after the continuous infusion than after the short infusion of ceftazidime (P ‫؍‬ 0.04). The mean serum ceftazidime concentration during the continuous infusion was 56.2 ؎ 23.2 g/ml; the mean peak and trough concentrations during the short infusions were 216.3 ؎ 71.5 and 12.1 ؎ 8.7 g/ml, respectively. The susceptibility profiles of the P. aeruginosa isolates remained unchanged and were similar for both regimens. Quality-of-life scores were similar whatever the treatment procedure, but 82% of the patients preferred the continuous-infusion regimen. Adverse events were not significantly different between the two regimens. In conclusion, the continuous infusion of ceftazidime did not increase its toxicity and appeared to be as efficient as short infusions in patients with cystic fibrosis as a whole, but it gave better results in patients harboring resistant isolates of P. aeruginosa.

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“…Many clinical studies assessing continuous and prolonged infusion were conducted through the 1990s, but only a few were clinical randomized controlled trials, mostly addressing only pharmacologic endpoints (38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49), and only two reported patients' outcomes. In 1979, Bodey and colleagues found that an antibiotic combination containing continuous-infusion cefamandole achieved the greatest cure rates in 490 febrile episodes with neutropenia (48).…”

Section: Historical Reviewmentioning

confidence: 99%

Continuous and Prolonged Intravenous β-Lactam Dosing: Implications for the Clinical Laboratory

2016

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SUMMARYBeta-lactam antibiotics serve as a cornerstone in the management of bacterial infections because of their wide spectrum of activity and low toxicity. Since resistance rates among bacteria are continuously on the rise and the pipeline for new antibiotics does not meet this trend, an optimization of current beta-lactam treatment is needed. This review provides an overview of optimization through use of prolonged- and continuous-infusion dosing strategies compared with more traditional intermittent infusions. Included is an overview of the scientific basis for using these nontraditional prolonged- and continuous-infusion-based regimens, with a focus on major areas in which the clinical laboratory can support the clinical use of these regimens.

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Continuous Infusion of Ceftazidime in Cystic Fibrosis

Cited by 35 publications

References 0 publications

Population Pharmacokinetic Comparison and Pharmacodynamic Breakpoints of Ceftazidime in Cystic Fibrosis Patients and Healthy Volunteers

Population Pharmacokinetic Comparison and Pharmacodynamic Breakpoints of Ceftazidime in Cystic Fibrosis Patients and Healthy Volunteers

Continuous versus Intermittent Infusions of Ceftazidime for Treating Exacerbation of Cystic Fibrosis

Continuous and Prolonged Intravenous β-Lactam Dosing: Implications for the Clinical Laboratory

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