Feasibility of Continuous Infusion of Cefiderocol in Conjunction with the Establishment of Therapeutic Drug Monitoring in Patients with Extensively Drug-Resistant Gram-Negative Bacteria.
Clin Drug Investig
; 43(4): 307-314, 2023 Apr.
Article
in English
| MEDLINE | ID: covidwho-2302059
ABSTRACT
BACKGROUND AND OBJECTIVE:
Resistance to antibacterial substances is a huge and still emerging issue, especially with regard to Gram-negative bacteria and in critically ill patients. We report a study in six patients infected with extensively drug-resistant Gram-negative bacteria in a limited outbreak who were successfully managed with a quasi-continuous infusion of cefiderocol.METHODS:
Patients were initially treated with prolonged infusions of cefiderocol over 3 h every 8 h, and the application mode was then switched to a quasi-continuous infusion of 2 g over 8 h, i.e. 6 g in 24 h. Therapeutic drug monitoring (TDM) was established using an in-house liquid chromatography-tandem mass spectrometry (LC-MS/MS) method.RESULTS:
Determined trough plasma concentrations were a median of 50.00 mg/L [95% confidence interval (CI) 27.20, 74.60] and steady-state plasma concentrations were a median of 90.96 mg/L [95% CI 37.80, 124]. No significant differences were detected with respect to acute kidney injury/continuous renal replacement therapy. Plasma concentrations determined from different modes of storage were almost equal when frozen or cooled, but markedly reduced when stored at room temperature.CONCLUSIONS:
(Quasi) continuous application of cefiderocol 6 g/24 h in conjunction with TDM is a feasible mode of application; the sample for TDM should either be immediately analyzed, cooled, or frozen prior to analysis.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Drug Monitoring
/
Tandem Mass Spectrometry
Limits:
Humans
Language:
English
Journal:
Clin Drug Investig
Journal subject:
Pharmacology
/
Drug Therapy
Year:
2023
Document Type:
Article
Affiliation country:
S40261-023-01257-8
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