Intravenous colistin in a patient with serious burns and borderline syndrome: The benefits of therapeutic drug monitoring

Bode‐Böger, Stefanie M.; Schopp, Brigitte E.; Tröger, Uwe; Martens‐Lobenhoffer, Jens; Kalousis, Konstantinos; Mailänder, P.

doi:10.1016/j.ijantimicag.2013.06.009

Cited by 31 publications

(18 citation statements)

References 14 publications

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“…The use of TDM as an aid to dosing CMS was reported for a small number of patients, but the benefit was not demonstrated in appropriately designed studies . For colistin, it is essential to ensure that sample collection, handling, and analysis are conducted appropriately to minimize ex vivo conversion of CMS to colistin .…”

Section: Clinical Questions and Recommendationsmentioning

confidence: 99%

“…6 And the substantial interpatient variability in PK cannot be accounted for by known patient factors (such variability is substantially greater for IV colistin than polymyxin B). 6,44,61 The use of TDM as an aid to dosing CMS was reported for a small number of patients, 86,87 but the benefit was not demonstrated in appropriately designed studies. 4 For colistin, it is essential to ensure that sample collection, handling, and analysis are conducted appropriately to minimize ex vivo conversion of CMS to colistin.…”

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confidence: 99%

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International Consensus Guidelines for the Optimal Use of the Polymyxins: Endorsed by the American College of Clinical Pharmacy (ACCP), European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Infectious Diseases Society of America (IDSA), International Society for Anti‐infective Pharmacology (ISAP), Society of Critical Care Medicine (SCCM), and Society of Infectious Diseases Pharmacists (SIDP)

et al. 2019

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The polymyxin antibiotics colistin (polymyxin E) and polymyxin B became available in the 1950s and thus did not undergo contemporary drug development procedures. Their clinical use has recently resurged, assuming an important role as salvage therapy for otherwise untreatable gram‐negative infections. Since their reintroduction into the clinic, significant confusion remains due to the existence of several different conventions used to describe doses of the polymyxins, differences in their formulations, outdated product information, and uncertainties about susceptibility testing that has led to lack of clarity on how to optimally utilize and dose colistin and polymyxin B. We report consensus therapeutic guidelines for agent selection and dosing of the polymyxin antibiotics for optimal use in adult patients, as endorsed by the American College of Clinical Pharmacy (ACCP), Infectious Diseases Society of America (IDSA), International Society of Anti‐Infective Pharmacology (ISAP), Society for Critical Care Medicine (SCCM), and Society of Infectious Diseases Pharmacists (SIDP). The European Society for Clinical Microbiology and Infectious Diseases (ESCMID) endorses this document as a consensus statement. The overall conclusions in the document are endorsed by the European Committee on Antimicrobial Susceptibility Testing (EUCAST). We established a diverse international expert panel to make therapeutic recommendations regarding the pharmacokinetic and pharmacodynamic properties of the drugs and pharmacokinetic targets, polymyxin agent selection, dosing, dosage adjustment and monitoring of colistin and polymyxin B, use of polymyxin‐based combination therapy, intrathecal therapy, inhalation therapy, toxicity, and prevention of renal failure. The treatment guidelines provide the first ever consensus recommendations for colistin and polymyxin B therapy that are intended to guide optimal clinical use.

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Section: Clinical Questions and Recommendationsmentioning

confidence: 99%

mentioning

confidence: 99%

International Consensus Guidelines for the Optimal Use of the Polymyxins: Endorsed by the American College of Clinical Pharmacy (ACCP), European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Infectious Diseases Society of America (IDSA), International Society for Anti‐infective Pharmacology (ISAP), Society of Critical Care Medicine (SCCM), and Society of Infectious Diseases Pharmacists (SIDP)

et al. 2019

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“…intervention to ensure attainment of PK/pharmacodynamic (PD) surrogate indicators of antibiotic efficacy to counteract the well-documented interindividual variability in PK observed in this population (10)(11)(12)(13)(14)(15). Moreover, TDM might also potentially improve burn patient outcomes (10,12,16,17). Currently, the Bayesian forecasting approach for estimation of individual PK parameters represents the gold standard approach for TDM (18,19).…”

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confidence: 99%

Population Pharmacokinetic Study of Amoxicillin-Treated Burn Patients Hospitalized at a Swiss Tertiary-Care Center

Fournier

Goutelle

Que

et al. 2018

Antimicrob Agents Chemother

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The objective of this study was to investigate the population pharmacokinetics (PK) of amoxicillin in ICU burn patients and the optimal dosage regimens. This was a prospective study involving 21 consecutive burn patients receiving amoxicillin. PK data were analyzed using nonlinear mixed-effects modeling. Monte-Carlo simulations assessed the influence of various amoxicillin dosage regimens with identified covariates on the probability to achieve a target (PTA) value of time during which free amoxicillin concentrations in plasma exceeded the MIC (T>MIC). A two-compartment model best described the data. Creatinine clearance (CL) and body weight (BW) influenced amoxicillin CL and central volume of distribution (), respectively. The median CL (Cockcroft-Gault formula) was high (128 ml/min), with 25% of patients having CLs of >150 ml/min. The CL, , and half-life () values at steady state for a patient with a CL of 110 ml/min and BW of 70 kg were 13.6 liters/h, 9.7 liters, and 0.8 h, respectively. Simulations showed that a target T>MIC of ≥50% was achieved (PTA > 90%) with standard amoxicillin dosage regimens (1 to 2 g every 6 to 8 h [q6-8h]) when the MIC was low (<1 mg/liter). However, increased dosages of up to 2 g/4 h were necessary in patients with augmented CLs or higher MICs. Prolonging amoxicillin infusion from 30 min to 2 h had a favorable effect on target attainment. In conclusion, this population analysis shows an increased amoxicillin CL and substantial CL PK variability in burn patients compared to literature data with nonburn patients. Situations of augmented CL and/or high bacterial MIC target values may require dosage increases and longer infusion durations. (This study has been registered at ClinicalTrials.gov under identifier NCT01965340.).

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“…Данные о применении ТЛМ с целью подбора дозы CMS доступны для небольшого числа пациентов [86,87], в хорошо спланированных исследованиях польза ТЛМ продемонстрирована не была [4]. В отношении колистина очень важно быть уверенным, что взятие образцов, обращение с ними и проведение анализа осуществляются должным образом с целью минимизации ex vivo конверсии CMS в колистин [33,59].…”

Section: какова рекомендуемая начальная суточная поддерживающая доunclassified

Review of the international consensus guidelines for the optimal use of the polymyxins

Елисеева

Azyzov

Зубарева

2019

CMAC

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Polymyxins are often the only agents that remain in vitro active against extensively resistant bacterial pathogens. However, the use of polymyxins is compromised by the number of unresolved issues, including the technical aspects of antimicrobial susceptibility testing, pharmacokinetic and pharmacodynamics parameters, optimal dosing regimens, and combined use with other antibiotics. All of the aspects of polymyxin use are discussed in detail in recently published «International consensus guidelines for the optimal use of the polymyxins», that was endorsed by the following professional societies: American College of Clinical Pharmacy (ACCP), European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Infectious Diseases Society of America (IDSA), International Society for Antiinfective Pharmacology (ISAP), Society of Critical Care Medicine (SCCM), and Society of Infectious Diseases Pharmacists (SIDP).

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Intravenous colistin in a patient with serious burns and borderline syndrome: The benefits of therapeutic drug monitoring

Cited by 31 publications

References 14 publications

Population Pharmacokinetic Study of Amoxicillin-Treated Burn Patients Hospitalized at a Swiss Tertiary-Care Center

Review of the international consensus guidelines for the optimal use of the polymyxins

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