Estimation of cefepime, piperacillin, and tazobactam clearance with iohexol-based glomerular filtration rate in paediatric patients.
Cefepime
Creatinine
Cystatin C
Iohexol
Piperacillin
Tazobactam
Journal
European journal of clinical pharmacology
ISSN: 1432-1041
Titre abrégé: Eur J Clin Pharmacol
Pays: Germany
ID NLM: 1256165
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
received:
01
12
2021
accepted:
04
03
2022
pubmed:
12
3
2022
medline:
18
5
2022
entrez:
11
3
2022
Statut:
ppublish
Résumé
Estimated glomerular filtration rate (eGFR) equations reflect kidney function imprecisely. We aimed to describe whether iohexol-based GFR or eGFRs predict clearance of cefepime, piperacillin, and tazobactam in pharmacokinetic (PK) models in this population and its clinical significance. Hospitalized patients (0.5-25 years) with haemato-oncological disease and infection receiving cefepime or piperacillin/tazobactam were included. PK samples were collected at a steady state concomitantly with samples for iohexol-based GFR. PK models were developed in NONMEM. Weight, postmenstrual age, iohexol-based GFR, different eGFR equations (Schwartz updated, Lund-Malmö revised, CKD-EPI, Bouvet, Schwartz cystatin C-based) were tested as covariates. Probabilities of neurotoxic/therapeutic concentrations were assessed by simulations. Fifteen patients receiving cefepime and 17 piperacillin/tazobactam were included (median (range) age 16.2 (1.9-26.0) and 10.5 (0.8-25.6) years, iohexol-based GFR 102 (68-140) and 116 (74-137) mL/min/1.73 m Iohexol-based GFR can predict better than eGFRs the clearance of cefepime, piperacillin, and tazobactam in children and young adults with haemato-oncological disease and infection, warranting further investigation as an indicator of renal function to improve targeting of therapeutic window. EudraCT 2015-000,631-32, EudraCT 2016-003,374-40 (24.10.2016).
Identifiants
pubmed: 35275224
doi: 10.1007/s00228-022-03307-0
pii: 10.1007/s00228-022-03307-0
doi:
Substances chimiques
Iohexol
4419T9MX03
Cefepime
807PW4VQE3
Creatinine
AYI8EX34EU
Tazobactam
SE10G96M8W
Piperacillin
X00B0D5O0E
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
989-1001Subventions
Organisme : Estonian Research Council
ID : PUT718
Organisme : Estonian Research Council
ID : PUT1197
Organisme : Estonian Research Council
ID : IUT34-24
Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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