Continuous versus intermittent infusion of cefepime in neurosurgical patients with post-operative intracranial infections |
| |
| Institution: | 1. Department of Critical Care Medicine, Beijing Fuxing Hospital, Capital Medical University, Beijing 100038, PR China;2. Department of Neurosurgery, Fujian Provincial Hospital, Fujian Medical University, Fuzhou 350001, PR China;3. Department of Cardiology, Fujian Provincial Hospital, Fujian Medical University, Fuzhou 350001, PR China;1. Centro de Pesquisas em Biologia Molecular e Funcional (CPBMF) and Instituto Nacional de Ciência e Tecnologia em Tuberculose (INCT-TB), Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil;2. Programa de Pós-Graduação em Biologia Celular e Molecular, PUCRS, Porto Alegre, RS, Brazil;3. Programa de Pós-Graduação em Medicina e Ciências da Saúde, PUCRS, Porto Alegre, RS, Brazil;4. Cátedra de Microbiología, Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Rosario, Argentina;5. Instituto de Toxicologia e Farmacologia, PUCRS, Porto Alegre, RS, Brazil;1. Institute of Parasitology, Vetsuisse Faculty, University of Berne, Länggassstrasse 122, CH-3012 Berne, Switzerland;2. College of Pharmacy, University of Nebraska Medical Center, 986025 Nebraska Medical Center, Omaha, NE, USA;3. Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland;1. Section of Infectious Diseases, New Mexico Veterans Healthcare System, Albuquerque, NM, USA;2. Division of Infectious Diseases, University of New Mexico Health Science Center, Albuquerque, NM, USA;1. Division of Infectious Diseases, University Medicine Cluster, National University Health System, Singapore;2. Department of Laboratory Medicine, National University Health System, Singapore;3. Microbiology & Immunology School of Pathology & Laboratory Medicine, The University of Western Australia and Division of Microbiology, Nedlands, Perth, WA, Australia;1. Centre for Liver Research and NIHR Liver Biomedical Research Unit, University of Birmingham, Birmingham, UK;2. Digestive Diseases Centre, NIHR Biomedical Research Unit, Queen''s Medical Centre, Nottingham, UK |
| |
| Abstract: | Cefepime is administered as an intermittent infusion (II); however, continuous infusion (CI) may be advantageous because β-lactam antibiotics exhibit time-dependent antibacterial activity. This retrospective, non-randomised, comparative study included 68 neurosurgical patients with post-operative intracranial infections treated with 4 g/day cefepime over 24 h as a CI (n = 34) or 2 g every 12 h as II (n = 34). CI controlled the intracranial infection more rapidly and effectively than II (6.6 ± 1.9 days vs. 7.8 ± 2.6 days; P = 0.036). By considering the minimum inhibitory concentrations (MICs) to be 4 μg/mL and 8 μg/mL, the percentage of time when the cefepime plasma or CSF concentrations were higher than the MIC (%T>MIC) was calculated for each patient. For plasma cefepime concentrations, the %T>MIC in the CI group was higher than in the II group (for MICs of 8 μg/mL, 100% vs. 75%, respectively). The mean calculated area under the curve (AUC) in the CI group was similar to the II group (1197.99 ± 72.15 μg h/mL vs. 890.84 ± 140.78 μg h/mL; P = 0.655). For CSF cefepime concentrations, the %T>MIC in the CI group was higher than in the II group (for MICs of 4 μg/mL and 8 μg/mL, 83.3% and 75% vs. 25% and 0%, respectively). The mean calculated AUC for the CI group was higher than the II group (220.56 ± 13.59 μg h/mL vs. 86.34 ± 5.69 μg h/mL; P = 0.003). Therefore, CI of cefepime significantly enhanced the antibacterial effect and reduced the treatment duration in neurosurgical patients with post-operative intracranial infections. |
| |
| Keywords: | Cefepime Continuous infusion Intermittent infusion Intracranial infection Minimum inhibitory concentration |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
