GIANNONI E, BUGNON D, COTTING J, GLAUSER M, MOREILLON P; Interscience Conference on Antimicrobial Agents and Chemotherapy (41st : 2001 : Chicago, Ill.).
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2001 Dec 16-19; 41: abstract no. A-936.
CHUV, Lausanne, Switzerland
BACKGROUND: ICU patients suffer physiological alterations that may alter drug pharmocokinetics (Pk). Recent experience with standard IMPC dosing resulted in sub-therapeutic levels in ICU children. We prospectively studied the Pk of HD-IMPC in this population. METHODS: 15 children (age 3.6, range 25 d - 12.9 y, weight 12.7 +/- 11.4 kg, PRISM score 8.7 +/- 5.7) were enrolled for 21 kinetics, either on the 1st dose or at steady state (> 4 days). IMPC was administered for 8 respiratory tract infections, 4 sepsis, 1 peritonitis, 1 urinary tract infection and 2 sepsis of unknown origin. Imipenem dosage was 100 mg/kg/day given in either 3 (tid) or 4 (qid) doses. Imipenem plasma levels were assayed by HPLC. RESULTS: [table: see text] CONCLUSION: Inter-individual variations were observed. However, all Pks were within the therapeutic range and no toxicity was recorded. The drug T1/2beta- paralleled the creatinine clearance (r = 0.68; p < 0.05). Time over MIC was 100% for 8/10 of all susceptible stains (including enterobacteria and P. aeruginosa), with clinical cure in all the patients. Yet, failure in bacteriological eradication occurred for 3 strains. Two of them (P. aeruginosa), with time over MIC < 100%, increased their MICs by >8x. HD-IMPC was safe and clinically effective. Drug monitoring may be important to ensure optimal therapy in this population.
Publication Types:
Keywords:
- Child
- Cilastatin
- Humans
- Imipenem
- Intensive Care Units
- Longitudinal Studies
- Peritonitis
- Population
- Population Groups
- Prospective Studies
- Respiratory Tract Infections
- Urinary Tract Infections
- administration & dosage
- imipenem-cilastatin
Other ID:
UI: 102269407
From Meeting Abstracts