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Antibiotic Dosing

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98 papers 25 to 100 followers
By Whitney Buckel Infectious Diseases Pharmacist
Elizabeth B Autry, Jeffrey M Rybak, Noelle R Leung, Brian M Gardner, Donna R Burgess, Michael I Anstead, Robert J Kuhn
STUDY OBJECTIVE: To evaluate the pharmacokinetics and pharmacodynamics of ceftaroline in adults with cystic fibrosis (CF). DESIGN: Open-label, single-center, prospective study. SETTING: University-affiliated teaching institution. PATIENTS: Eight patients with a diagnosis of CF and a history of methicillin-resistant Staphylococcus aureus who were treated with ceftaroline between November 2013 and September 2014. INTERVENTION: All patients received at least three doses of intravenous ceftaroline 600 mg every 12 hours, administered as a 60-minute infusion, to achieve steady-state concentrations before blood sample collection...
January 2016: Pharmacotherapy
Derek N Bremmer, David P Nicolau, Pam Burcham, Anil Chunduri, Ganesh Shidham, Karri A Bauer
Limited data are available on ceftolozane/tazobactam dosing in patients receiving continuous renal replacement therapy (CRRT). Thus we performed a pharmacokinetic analysis of intravenous ceftolozane/tazobactam in a critically ill patient receiving CRRT at our medical center. A 47-year-old critically ill man with multidrug-resistant Pseudomonas aeruginosa pneumonia, bacteremia, and osteomyelitis was receiving ceftolozane/tazobactam 3 g (ceftolozane 2 g/tazobactam 1 g) every 8 hours while receiving continuous venovenous hemodiafiltration (CVVHDF)...
May 2016: Pharmacotherapy
Jamielynn C Sebaaly, Shawn H MacVane, Tanna B Hassig
PURPOSE: Results of a study of the relationship among voriconazole dosages, serum concentrations, adverse effects, and clinical outcomes are presented. METHODS: A retrospective chart review was conducted that included all patients who had at least one voriconazole concentration drawn between July 1, 2009, and August 15, 2014, at a single academic medical center. The primary outcome was the proportion of patients with initial voriconazole concentrations in the target range...
March 1, 2016: American Journal of Health-system Pharmacy: AJHP
Devyani Deshpande, Jotam G Pasipanodya, Tawanda Gumbo
Mycobacterium aviumcomplex is now the leading mycobacterial cause of chronic pneumonia in the United States. Macrolides and ethambutol form the backbone of the regimen used in the treatment of pulmonary disease. However, therapy outcomes remain poor, with microbial cure rates of 4% in cavitary disease. The treatment dose of azithromycin has mostly been borrowed from that used to treat other bacterial pneumonias; there are no formal dose-response studies in pulmonaryM. aviumdisease and the optimal dose is unclear...
April 2016: Antimicrobial Agents and Chemotherapy
Kensuke Shoji, John S Bradley, Michael D Reed, John N van den Anker, Christine Domonoske, Edmund V Capparelli
The Clinical and Laboratory Standards Institute (CLSI) revised cefepime (CFP) breakpoints forEnterobacteriaceaein 2014, and MICs of 4 and 8 μg/ml were reclassified as susceptible-dose dependent (SDD). Pediatric dosing to provide therapeutic concentrations against SDD organisms has not been defined. CFP pharmacokinetics (PK) data from published pediatric studies were analyzed. Population PK parameters were determined using NONMEM, and Monte Carlo simulation was performed to determine an appropriate CFP dosage regimen for SDD organisms in children...
April 2016: Antimicrobial Agents and Chemotherapy
Luning Zhuang, Yang He, Huiming Xia, Yajun Liu, Sherwin K B Sy, Hartmut Derendorf
OBJECTIVES: Gentamicin is widely used in end-stage renal disease (ESRD) patients for the treatment of infections. The goal of this study was to find the most reasonable dosing regimen for gentamicin in ESRD patients receiving haemodialysis. METHODS: The in vitro antimicrobial activity of gentamicin was evaluated by static and dynamic time-kill experiments against three bacterial strains of MSSA, MRSA and Pseudomonas aeruginosa. A semi-mechanistic pharmacokinetic/pharmacodynamic (PK/PD) model was established afterwards, allowing the characterization of the antibacterial effect of gentamicin in the human body...
April 2016: Journal of Antimicrobial Chemotherapy
S van Koningsbruggen-Rietschel, H E Heuer, N Merkel, H G Posselt, D Staab, C Sieder, J Ziegler, F Krippner, E Rietschel
OBJECTIVES: We evaluated the pharmacokinetics, safety and tolerability of two different continuous treatment regimens of tobramycin inhalation solution (TIS) in 29 cystic fibrosis (CF) patients chronically infected with Pseudomonas aeruginosa. PATIENTS AND METHODS: In this randomized, multicentre, open-label, two-period crossover study, TIS (300 mg/5 mL) was administered via PARI eFlow(®) rapid once daily and twice daily each for 8 weeks. Serum pharmacokinetics of these two regimens was analysed...
March 2016: Journal of Antimicrobial Chemotherapy
Tamara Mihic, Ivy Chow, Vincent Mabasa
No abstract text is available yet for this article.
February 2016: Annals of Pharmacotherapy
Mieke Carlier, Jason A Roberts, Veronique Stove, Alain G Verstraete, Jeffrey Lipman, Jan J De Waele
De-escalation of empirical antibiotic therapy is often included in antimicrobial stewardship programs in critically ill patients, but differences in target attainment when antibiotics are switched are rarely considered. The primary objective of this study was to compare the fractional target attainments of contemporary dosing of empirical broad-spectrum β-lactam antibiotics and narrower-spectrum antibiotics for a number pathogens for which de-escalation may be considered. The secondary objective was to determine whether alternative dosing strategies improve target attainment...
August 2015: Antimicrobial Agents and Chemotherapy
C H Chilton, G S Crowther, S L Todhunter, H Ashwin, C M Longshaw, A Karas, M H Wilcox
BACKGROUND: Fidaxomicin treatment reduces the risk of recurrent Clostridium difficile infection (CDI) compared with vancomycin. Extending duration of fidaxomicin therapy may further reduce recurrence. We compared the efficacy of four extended fidaxomicin regimens in an in vitro model of CDI. METHODS: Four gut models were primed with human faeces, spiked with C. difficile spores (PCR ribotype 027) and clindamycin instilled (33.9 mg/L, four-times daily, 7 days) to induce simulated CDI...
September 2015: Journal of Antimicrobial Chemotherapy
Cristina Gervasoni, Roberto Bergia, Valeria Cozzi, Emilio Clementi, Dario Cattaneo
No abstract text is available yet for this article.
October 2015: Journal of Antimicrobial Chemotherapy
Claire Roger, Bastian Nucci, Benjamin Louart, Arnaud Friggeri, Haroun Knani, Alexandre Evrard, Jean-Philippe Lavigne, Bernard Allaouchiche, Jean-Yves Lefrant, Jason A Roberts, Laurent Muller
OBJECTIVES: Low first-dose peak serum concentrations of amikacin and gentamicin are commonly reported in ICU patients. The present study aimed to assess whether 30 mg/kg amikacin or 8 mg/kg gentamicin achieved target concentrations in ICU patients with severe sepsis. PATIENTS AND METHODS: Sixty-three ICU patients (Simplified Acute Physiology Score II = 43 ± 16) with severe sepsis and an indication for intravenous amikacin (n = 47) or gentamicin (n = 16) were included...
January 2016: Journal of Antimicrobial Chemotherapy
C Roger, L Muller, S C Wallis, B Louart, G Saissi, J Lipman, J Y Lefrant, J A Roberts
OBJECTIVES: Few data are available to guide linezolid dosing during renal replacement therapy. The objective of this study was to compare the population pharmacokinetics of linezolid during continuous venovenous haemofiltration (CVVHF, 30 mL/kg/h) and continuous venovenous haemodiafiltration (CVVHDF, 15 mL/kg/h + 15 mL/kg/h). METHODS: Patients requiring linezolid 600 mg iv every 12 h and CVVHF or CVVHDF were eligible for this prospective study. Seven blood samples were collected over one dosing interval and analysed by a validated chromatographic method...
February 2016: Journal of Antimicrobial Chemotherapy
Samuel L Aitken, Jian Zhou, Shashank S Ghantoji, Dimitrios P Kontoyiannis, Roy B Jones, Vincent H Tam, Roy F Chemaly
OBJECTIVES: The objective of this study was to evaluate the pharmacokinetics and safety of cidofovir administered via the intravesicular route to patients with haemorrhagic cystitis following allogeneic HSCT (allo-HSCT). METHODS: Patients with gross haematuria and confirmed BK or adenovirus viruria following allo-HSCT were prospectively enrolled in an open-label pharmacokinetic study ( registration: NCT01816646). Three hours after an oral probenecid dose (2 g), cidofovir (2...
March 2016: Journal of Antimicrobial Chemotherapy
Mahipal G Sinnollareddy, Michael S Roberts, Jeffrey Lipman, Melissa Lassig-Smith, Therese Starr, Thomas Robertson, Sandra L Peake, Jason A Roberts
The objective of the study was to describe the subcutaneous interstitial fluid (ISF) pharmacokinetics of fluconazole in critically ill patients with sepsis. This prospective observational study was conducted at two tertiary intensive care units in Australia. Serial fluconazole concentrations were measured over 24 h in plasma and subcutaneous ISF using microdialysis. The concentrations in plasma and microdialysate were measured using a validated high-performance liquid chromatography system with electrospray mass spectrometer detector method...
February 2016: Antimicrobial Agents and Chemotherapy
Athena L V Hobbs, Katherine M Shea, Kirsten M Roberts, Mitchell J Daley
Augmented renal clearance (ARC) has been reported in approximately 30-65% of patients in the intensive care unit (ICU) despite the presence of a normal serum creatinine concentration. In certain ICU patient populations (e.g., patients with sepsis or trauma), the incidence increases to roughly 50-85%. Risk factors for ARC include the following: age younger than 50-55 years, male sex, higher diastolic blood pressure, fewer comorbidities, and a lower Acute Physiology and Chronic Health Evaluation II (APACHE II) or modified Sequential Organ Failure Assessment (SOFA) score at ICU admission...
November 2015: Pharmacotherapy
Roger L Nation, Samira M Garonzik, Jian Li, Visanu Thamlikitkul, Evangelos J Giamarellos-Bourboulis, David L Paterson, John D Turnidge, Alan Forrest, Fernanda P Silveira
BACKGROUND: The US Food and Drug Administration (FDA) and European Medicines Agency (EMA) have approved updated dose recommendations for intravenous colistin in patients with various degrees of renal function. We assessed the recommendations in relation to their ability to achieve clinically relevant plasma colistin concentrations. METHODS: Pharmacokinetic data from 162 adult critically ill patients (creatinine clearance range, 5.4-211 mL/min) were used to determine the average steady-state plasma colistin concentration (Css,avg) that would be achieved if each patient received the FDA or EMA dose...
March 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
R A Evans, T M Clifford, S Tang, T Au, A M Fugit
BACKGROUND: Pneumocystis jirovecii pneumonia (PCP) remains a concern after organ transplantation. In 2005, the University of Kentucky (UK) Transplant Center implemented a novel dosing regimen of weekly dapsone as an alternative for patients with contraindications or intolerability to trimethoprim-sulfamethoxazole (TMP-SMZ), which remains the drug of choice. The purpose of this study was to compare the efficacy of weekly dapsone with TMP-SMZ in preventing PCP post transplantation. METHODS: A single-center, cohort, retrospective review of kidney and liver transplant patients from January 2005 to December 2012 was conducted...
December 2015: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Don-Kelena Awissi, Annie Beauchamp, Elisabeth Hébert, Viviane Lavigne, Danya Lucia Munoz, Geneviève Lebrun, Michel Savoie, Mylène Fagnan, Julie Amyot, Nicolas Tétreault, Robert Robitaille, France Varin, Christian Lavallée, Vincent Pichette, Martine Leblanc
STUDY OBJECTIVE: To evaluate the pharmacokinetic and pharmacodynamic profiles of piperacillin-tazobactam administered as a 4-hour infusion in critically ill patients undergoing continuous renal replacement therapy (CRRT). DESIGN: Prospective, observational, pharmacokinetic study. SETTING: Intensive care unit of a tertiary care hospital in Montréal, Canada. PATIENTS: Twenty critically ill adults who were undergoing continuous venovenous hemodiafiltration and receiving a 4-hour infusion of piperacillin 4 g-tazobactam 0...
June 2015: Pharmacotherapy
T Brosh-Nissimov, R Ben-Ami
Targeting fluconazole therapy to achieve predefined pharmacodynamic goals has been suggested as a means of optimizing the treatment of patients with candidaemia. However, data regarding species-specific dosing targets are inconclusive. We retrospectively analysed a cohort of 75 adult patients with Candida bloodstream infection (BSI) who received initial treatment with fluconazole for ≥48 h (36 Candida albicans and 39 non-albicans Candida (NAC)). Fluconazole dose, the dose/MIC ratio and the 24-h area under the concentration-time curve (AUC24)/MIC ratio were determined for each patient, and classification and regression tree analysis was used to determine breakpoints for significant interactions with 30-day survival...
November 2015: Clinical Microbiology and Infection
2015-11-14 19:30:49
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