Pharmacokinetic analysis of flomoxef in children undergoing cardiopulmonary bypass and modified ultrafiltration

Abstract

The pharmacokinetics of flomoxef in children undergoing CPB and MUF were well fitted to a modified two-compartment model. Using the kinetic data from this study, the individualization of dosage regimens for prophylactic use of flomoxef might be possible.

Skeletal muscle and plasma concentrations of cefazolin during cardiac surgery in infants

“…These differences were most profound during DHCA, suggesting that plasma levels might not be predictive of the skeletal muscle concentrations in all patients, highlighting one of the limitations of previous studies of prophylactic antibiotics in children undergoing CPB using the plasma level as a surrogate for the tissue concentration. [20][21][22][23] Furthermore, despite the routine use of cefazolin for SSI prophylaxis in congenital cardiac surgery, only 1 published study has measured cefazolin in plasma, and that study was limited because it did not report the unbound cefazolin levels or tissue concentrations. 21 The most common side effect related to the microdialysis catheters was minor bleeding (defined as 1-3 drops of blood) at the insertion sites.…”

“…18,19 PK studies of prophylactic antibiotics during CPB in children have used both total and unbound plasma concentrations as a surrogate for the tissue drug concentrations. [20][21][22][23] However, the plasma concentrations might not accurately reflect the antimicrobial exposures in the tissue where an infection occurs. Tissue concentrations might represent the true target for SSI prevention and could be important to better determine the recommendations for prophylactic antibiotic dosing.…”

Current ultrafiltration techniques before, during and after pediatric cardiopulmonary bypass procedures

“…Masuda et al found that almost one-fourth of the given dose of Flomoxef (a second generation cephalosporin antibiotic with a broad spectrum) was removed by MUF in children undergoing cardiac surgery. 30…”

Effects of Peritoneal Dialysis on Pharmacotherapy: A Deductive Pharmacokinetic-model Approach to Predict Drug Concentration Profiles in Plasma and Peritoneal Fluid

“…However, the PK parameters of a drug can change with disease, with concomitant drug therapy, and even within the same individual according to the clinical situation, such as being connected to a heart-lung machine 13) or undergoing PD. Among the deductively produced PK modeling approaches, the physiological concept of an integrated PK (physiological PK) model is successful in complying with the diversity of prediction conditions.…”

“…We have reported that such deductive modifications have implications for individualized prophylactic use of antibiotics in children undergoing cardiopulmonary bypass surgery and modified ultrafiltration. 13) Propranolol hydrochloride (PPL), a sympatholytic non-selective ¢-blocker, 14) is administered to patients to treat hypertension. Cefazolin sodium (CEZ) is clinically effective against infections caused by staphylococci and streptococci of Gram-positive bacteria and is generally used to treat moderately severe bacterial infections involving the lungs, bones, joints, stomach, blood, heart valves, and urinary tract.…”