Pharmacokinetics of Amoxicillin and Cefepime During Prolonged Intermittent Renal Replacement Therapy: A Case Report-Reference-Cited by-同舟云学术

Pharmacokinetics of Amoxicillin and Cefepime During Prolonged Intermittent Renal Replacement Therapy: A Case Report

Published:2020-07-23 Issue: Volume: Page:78-83
ISSN:2053-4248
Container-title:EMJ Nephrology
language:
Short-container-title:EMJ Nephrol

Author:

Xu Jessica H¹,Cheng Vesa²,Rawlins Matthew¹,Lennon Joanne¹,Morgan David³,McWhinney Brett C⁴,Ungerer Jacobus PJ⁵,Wilde Alice⁴,Dyer John⁶,Roberts Jason A⁷

Affiliation:

1. Department of Pharmacy, Fiona Stanley Hospital, Perth, Australia

2. University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia

3. Department of Intensive Care Medicine, Fiona Stanley Hospital, Perth, Australia

4. Department of Chemical Pathology, Pathology Queensland, Brisbane, Australia

5. Department of Chemical Pathology, Pathology Queensland, Brisbane, Australia; School of Biomedical Sciences, University of Queensland, Brisbane, Australia

6. Department of Infectious Diseases, Fiona Stanley Hospital, Perth, Australia

7. University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia; Departments of Pharmacy and Intensive Care Medicine, Royal Brisbane and Women’s Hospital, Brisbane, Australia; Centre for Translational Anti-Infective Pharmacodynamics, School of Pharmacy, The University of Queensland, Brisbane, Australia

Abstract

Prolonged intermittent renal replacement therapy (PIRRT) is an emerging form of renal replacement therapy in critically ill patients, but dosing data for antibiotics such as amoxicillin and cefepime are scarce and limited. This case report describes the effect of PIRRT on the plasma pharmacokinetics of amoxicillin and cefepime in a 69-year-old, critically ill patient with a polymicrobial intra-abdominal infection. Blood samples taken over 2 days, including a 7-hour PIRRT session, were analysed and a two-compartment model was used to describe cefepime and amoxicillin clearance and dosing requirements during PIRRT and off-PIRRT in this patient. Based on these data, an off-PIRRT dose of 1 g amoxicillin 12-hourly and cefepime 2 g daily with an on-PIRRT dose of 1 g amoxicillin 8-hourly and cefepime 2 g 12-hourly was deemed appropriate.

Publisher

European Medical Group

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