1887

Abstract

Cefuroxime is an important antibiotic to treat several serious infections. Rapid elimination through the kidneys and the variation in MICs of various susceptible pathogens such as and give rise to dosing issues, especially in otherwise healthy patients.

To investigate the probability of target attainment (PTA) for obtaining the optimal dosage regimens for cefuroxime in healthy young people.

Two weeks apart 750 and 1500 mg cefuroxime were administered as an intravenous bolus to 20 healthy volunteers (mean age: 27 years). Population modelling and simulation studies were done based on the obtained data for cefuroxime plasma concentration.

With a target value of time above MIC ( ) greater than 50 % the simulations revealed that a PTA of >99 % is obtained for with a dosage regimen of 750 mg q12h. For and the PTA was <90 % even with the highest, simulated dosage of 1500 mg q6h. For a dosage of 1500 mg q8h gave a PTA above 97 %.

is most likely treatable with a two-daily dose of 750 mg cefuroxime. Not treatable are and . For 1500 mg q8h constitutes an optimal dosing schedule.

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2020-01-20
2020-02-28
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References

  1. Foord RD. Cefuroxime: human pharmacokinetics.. Antimicrob Agents Chemother 1976;9: 741– 747 [CrossRef]
    [Google Scholar]
  2. EUCAST Mic distribution website. http://eucast.org/mic_distributions_and_ecoffs/ 11 July 2019
  3. Carlier M, Noë M, Roberts JA, Stove V, Verstraete AG et al. Population pharmacokinetics and dosing simulations of cefuroxime in critically ill patients: non-standard dosing approaches are required to achieve therapeutic exposures. J Antimicrob Chemother 2014;69: 2797– 2803 [CrossRef]
    [Google Scholar]
  4. Alqahtani SA, Alsultan AS, Alqattan HM, Eldemerdash A, Albacker TB. Population pharmacokinetic model-based evaluation of standard dosing regimens for cefuroxime used in coronary artery bypass graft surgery with cardiopulmonary bypass. Antimicrob Agents Chemother 2018;62: e02241– 17 [CrossRef]
    [Google Scholar]
  5. Broekhuysen J, Deger F, Douchamps J, Freschi E, Mal N et al. Pharmacokinetic study of cefuroxime in the elderly. Br J Clin Pharmacol 1981;12: 801– 805 [CrossRef]
    [Google Scholar]
  6. Janssen PKC, Foudraine NA, Burgers DMT, Neef K, le Noble JLML. Population pharmacokinetics of cefuroxime in critically ill patients receiving continuous venovenous hemofiltration with regional citrate anticoagulation and a phosphate-containing replacement fluid. Ther Drug Monit 2016;38: 699– 705 [CrossRef]
    [Google Scholar]
  7. Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron 1976;16: 31– 41 [CrossRef]
    [Google Scholar]
  8. Sandberg A, Jensen KS, Baudoux P, Van Bambeke F, Tulkens PM et al. Intra- and extracellular activity of linezolid against Staphylococcus aureus in vivo and in vitro. J Antimicrob Chemother 2010;65: 962– 973 [CrossRef]
    [Google Scholar]
  9. Neely MN, van Guilder MG, Yamada WM, Schumitzky A, Jelliffe RW. Accurate detection of outliers and subpopulations with Pmetrics, a nonparametric and parametric pharmacometric modeling and simulation package for R. Ther Drug Monit 2012;34: 467– 476 [CrossRef]
    [Google Scholar]
  10. Holford N, Heo Y-A, Anderson B. A pharmacokinetic standard for babies and adults. J Pharm Sci 2013;102: 2941– 2952 [CrossRef]
    [Google Scholar]
  11. Asín-Prieto E, Soraluce A, Trocóniz IF, Campo Cimarras E, Sáenz de Ugarte Sobrón J et al. Population pharmacokinetic models for cefuroxime and metronidazole used in combination as prophylactic agents in colorectal surgery: model-based evaluation of standard dosing regimens. Int J Antimicrob Agents 2015;45: 504– 511 [CrossRef]
    [Google Scholar]
  12. Mouton JW, Dudley MN, Cars O, Derendorf H, Drusano GL. Standardization of pharmacokinetic/pharmacodynamic (PK/PD) terminology for anti-infective drugs: an update. J Antimicrob Chemother 2005;55: 601– 607 [CrossRef]
    [Google Scholar]
  13. Bundtzen RW, Toothaker RD, Nielson OS, Madsen PO, Welling PG et al. Pharmacokinetics of cefuroxime in normal and impaired renal function: comparison of high-pressure liquid chromatography and microbiological assays. Antimicrob Agents Chemother 1981;19: 443– 449 [CrossRef]
    [Google Scholar]
  14. Norrby R, Foord RD, Price JD, Hedlund P. Pharmacokinetic and clinical studies on cefuroxime. Proc R Soc Med 1977;70: 25– 33
    [Google Scholar]
  15. Thønnings S, Jansåker F, Gradel KO, Styrishave B, Knudsen JD. Cefuroxime compared to piperacillin/tazobactam as empirical treatment of Escherichia coli bacteremia in a low Extended-spectrum beta-lactamase (ESBL) prevalence cohort. Infect Drug Resist 2019;12: 1257– 1264 [CrossRef]
    [Google Scholar]
  16. Chang U-I, Kim HW, Wie S-H. Use of cefuroxime for women with community-onset acute pyelonephritis caused by cefuroxime-susceptible or -resistant Escherichia coli. Korean J Intern Med 2016;31: 145– 155 [CrossRef]
    [Google Scholar]
  17. Nissen JL, Skov R, Knudsen JD, Østergaard C, Schønheyder HC et al. Effectiveness of penicillin, dicloxacillin and cefuroxime for penicillin-susceptible Staphylococcus aureus bacteraemia: a retrospective, propensity-score-adjusted case-control and cohort analysis. J Antimicrob Chemother 2013;68: 1894– 1900 [CrossRef]
    [Google Scholar]
  18. Ambrose PG, Quindliani R, Nightingale CH, Nicolau DP. Continuous vs. intermittent infusion of cefuroxime for the treatment of community-acquired pneumonia. Infect Dis Clin Pract 1998;7: 463– 470 [CrossRef]
    [Google Scholar]
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