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1.
Antibiotics (Basel) ; 10(10)2021 Oct 09.
Article in English | MEDLINE | ID: covidwho-1480539

ABSTRACT

1.1 Based on the initial data from Table 1 there were errors in the original article [...].

2.
Antibiotics (Basel) ; 10(6)2021 May 28.
Article in English | MEDLINE | ID: covidwho-1285366

ABSTRACT

Cefiderocol is a new siderophore-cephalosporin for the treatment of multi-drug resistant Gram-negative pathogens. As a reserve agent, it will and should be used primarily in critically ill patients in the upcoming years. Due to the novelty of the substance little data on the pharmacokinetics in critically ill patients with septic shock and renal failure (including continuous renal replacement therapy and cytokine adsorber therapy) is available. We performed therapeutic drug monitoring in a cohort of five patients treated with cefiderocol, to improve the knowledge on pharmacokinetics in this vulnerable patient population. As expected for a cephalosporin with predominantly renal elimination the maintenance dose could be reduced in patients with renal impairment or on continuous renal replacement therapy. The manufacturer's dosing instructions were sufficient to achieve a drug level well above the MIC. However, the addition of a cytokine adsorber might reduce serum levels substantially, so that in this context therapeutic drug monitoring and dose adjustment are recommended.

3.
Medicine (Baltimore) ; 100(22): e26253, 2021 Jun 04.
Article in English | MEDLINE | ID: covidwho-1258821

ABSTRACT

ABSTRACT: Pathophysiological changes are important risk factors for critically ill patients with pneumonia manifesting sub-therapeutic antibiotic exposures during empirical treatment. The effect of coronavirus disease 2019 (COVID-19) on antibiotic dosing requirements is uncertain. We aimed to determine the effect of COVID-19 on ß-lactam pharmacokinetics (PK) and PK target attainment in critically ill patients with a personalized dosing strategy.Retrospective, single-center analysis of COVID-19 ± critically ill patients with pneumonia (community-acquired pneumonia or hospital-acquired pneumonia) who received continuous infusion of a ß-lactam antibiotic with dosing personalized through dosing software and therapeutic drug monitoring. A therapeutic exposure was defined as serum concentration between (css) 4 to 8 times the EUCAST non-species related breakpoint).Data from 58 patients with pneumonia was analyzed. Nineteen patients were tested COVID-19-positive before the start of the antibiotic therapy for community-acquired pneumonia or hospital-acquired pneumonia. Therapeutic exposure was achieved in 71% of COVID-19 patients (68% considering all patients). All patients demonstrated css above the non-species-related breakpoint. Twenty percent exceeded css above the target range (24% of all patients). The median ß-lactam clearance was 49% compared to ß-lactam clearance in a standard patient without a significant difference regarding antibiotic, time of sampling or present COVID-19 infection. Median daily doses were 50% lower compared to standard bolus dosing.COVID-19 did not significantly affect ß-lactam pharmacokinetics in critically ill patients. Personalized ß-lactam dosing strategies were safe in critically ill patients and lead to high PK target attainment with less resources.


Subject(s)
COVID-19 Drug Treatment , beta-Lactams/administration & dosage , beta-Lactams/pharmacokinetics , Aged , Aged, 80 and over , Body Mass Index , Critical Illness , Dose-Response Relationship, Drug , Drug Monitoring , Female , Humans , Infusions, Intravenous , Male , Metabolic Clearance Rate , Middle Aged , Retrospective Studies , SARS-CoV-2 , Severity of Illness Index , beta-Lactams/economics , beta-Lactams/therapeutic use
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