Estimation of cefepime, piperacillin, and tazobactam clearance with iohexol-based glomerular filtration rate in paediatric patients.


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
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

989-1001

Subventions

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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Auteurs

Hiie Soeorg (H)

Department of Microbiology, Institute of Biomedicine and Translational Medicine, University of Tartu, Ravila 19, 50411, Tartu, Estonia. hiie.soeorg@ut.ee.

Aveli Noortoots (A)

Department of Microbiology, Institute of Biomedicine and Translational Medicine, University of Tartu, Ravila 19, 50411, Tartu, Estonia.

Maarja Karu (M)

Department of Haematology and Oncology, Clinic of Paediatrics, Tallinn Children's Hospital, Tallinn, Estonia.

Kadri Saks (K)

Department of Haematology and Oncology, Clinic of Paediatrics, Tallinn Children's Hospital, Tallinn, Estonia.

Jana Lass (J)

Pharmacy Department, Tartu University Hospital, Tartu, Estonia.

Irja Lutsar (I)

Department of Microbiology, Institute of Biomedicine and Translational Medicine, University of Tartu, Ravila 19, 50411, Tartu, Estonia.

Lenne-Triin Kõrgvee (LT)

Department of Pharmacology, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia.
Haematology and Oncology Clinic, Tartu University Hospital, Tartu, Estonia.

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