Journal of Antimicrobial Chemotherapy, Vol 40, 125-133, Copyright © 1997 by The British Society for Antimicrobial Chemotherapy
AA Vinks, RW Brimicombe, HG Heijerman and W Bakker
Acute exacerbations of Pseudomonas aeruginosa lung infections were treated
with ceftazidime by continuous infusion in 17 adult patients with cystic
fibrosis at home. Ceftazidime was delivered via an infusion pump and the
effects of this 3 week home intravenous antibiotic treatment (HIVAT) were
prospectively studied over a 2 year period. Patients with cystic fibrosis
(eight male and nine female patients; mean age 26.9 +/- 7.6 years, range
15-52 years), received a total of 33 courses of continuous ceftazidime (100
mg/kg/24 h). Clinical data were collected at the start, the end and 4-6
weeks after the end of treatment in 12 patients. Ceftazidime
pharmacokinetic data during continuous infusion were obtained from ten
patients. The treatment was supervised by the clinician without home
visits. All 25 clinically evaluable courses in 12 patients proved
efficacious. The mean duration of the courses was 21 days. The entire
antibiotic course was administered at home in 88% of the courses. The other
12% was started for 2-3 days as an inpatient. Objective clinical parameters
significantly improved. Clinical improvement was noted in 91% of the
patients, and lasted at least until 4-6 weeks after the end of the
treatment in 70%. The number of cultures positive for P. aeruginosa
decreased significantly during antibiotic treatment. Bacterial count
returned to pretreatment values 4-6 weeks after treatment. Multiple courses
of ceftazidime monotherapy did not result in a lasting increase of
ceftazidime-resistant pseudomonas strains. Total body clearance was 9.1 +/-
1.3 L/h. The steady-state ceftazidime serum concentration during continuous
infusion was 28.4 +/- 5.0 mg/L. Sputum concentrations were in the range of
0.5-13 mg/L (3.9 +/- 4.0 mg/L). In conclusion, HIVAT with ceftazidime
administered by continuous infusion proved clinically effective and did not
result in an increase in lasting resistance.
ORIGINAL ARTICLES
Continuous infusion of ceftazidime in cystic fibrosis patients during home treatment: clinical outcome, microbiology and pharmacokinetics
The Hague Hospitals Central Pharmacy, The Hague, The Netherlands. kkgt@rijnhaave.nl
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  D. Hubert, E. Le Roux, T. Lavrut, B. Wallaert, P. Scheid, D. Manach, D. Grenet, I. Sermet-Gaudelus, S. Ramel, C. Cracowski, et al. Continuous versus Intermittent Infusions of Ceftazidime for Treating Exacerbation of Cystic Fibrosis Antimicrob. Agents Chemother., September 1, 2009; 53(9): 3650 - 3656. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Moriyama, S. A Henning, M. M Neuhauser, R. L Danner, and T. J Walsh Continuous-Infusion {beta}-Lactam Antibiotics During Continuous Venovenous Hemofiltration for the Treatment of Resistant Gram-Negative Bacteria Ann. Pharmacother., July 1, 2009; 43(7): 1324 - 1337. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. A. Vinks, R. N. van Rossem, R. A. A. Mathot, H. G. M. Heijerman, and J. W. Mouton Pharmacokinetics of Aztreonam in Healthy Subjects and Patients with Cystic Fibrosis and Evaluation of Dose-Exposure Relationships Using Monte Carlo Simulation Antimicrob. Agents Chemother., September 1, 2007; 51(9): 3049 - 3055. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. B. Bulitta, S. B. Duffull, M. Kinzig-Schippers, U. Holzgrabe, U. Stephan, G. L. Drusano, and F. Sorgel Systematic Comparison of the Population Pharmacokinetics and Pharmacodynamics of Piperacillin in Cystic Fibrosis Patients and Healthy Volunteers Antimicrob. Agents Chemother., July 1, 2007; 51(7): 2497 - 2507. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. K. Lau, D. Mercer, K. M. Itani, D. P. Nicolau, J. L. Kuti, D. Mansfield, and A. Dana Randomized, Open-Label, Comparative Study of Piperacillin-Tazobactam Administered by Continuous Infusion versus Intermittent Infusion for Treatment of Hospitalized Patients with Complicated Intra-Abdominal Infection Antimicrob. Agents Chemother., November 1, 2006; 50(11): 3556 - 3561. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Klekner, K. Bagyi, L. Bognar, A. Gaspar, M. Andrasi, and J. Szabo Effectiveness of cephalosporins in the sputum of patients with nosocomial bronchopneumonia. J. Clin. Microbiol., September 1, 2006; 44(9): 3418 - 3421. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. M. Moskowitz, J. M. Foster, J. C. Emerson, R. L. Gibson, and J. L. Burns Use of Pseudomonas biofilm susceptibilities to assign simulated antibiotic regimens for cystic fibrosis airway infection J. Antimicrob. Chemother., November 1, 2005; 56(5): 879 - 886. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Baririan, H. Chanteux, E. Viaene, H. Servais, and P. M. Tulkens Stability and compatibility study of cefepime in comparison with ceftazidime for potential administration by continuous infusion under conditions pertinent to ambulatory treatment of cystic fibrosis patients and to administration in intensive care units J. Antimicrob. Chemother., March 1, 2003; 51(3): 651 - 658. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Lubasch, S. Luck, H. Lode, H. Mauch, J. Lorenz, P. Bolcskei, T. Welte, and the COPD study group Optimizing ceftazidime pharmacodynamics in patients with acute exacerbation of severe chronic bronchitis J. Antimicrob. Chemother., March 1, 2003; 51(3): 659 - 664. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. A. Vinks, J. G. den Hollander, S. E. Overbeek, R. W. Jelliffe, and J. W. Mouton Population Pharmacokinetic Analysis of Nonlinear Behavior of Piperacillin during Intermittent or Continuous Infusion in Patients with Cystic Fibrosis Antimicrob. Agents Chemother., February 1, 2003; 47(2): 541 - 547. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Viaene, H. Chanteux, H. Servais, M.-P. Mingeot-Leclercq, and P. M. Tulkens Comparative Stability Studies of Antipseudomonal {beta}-Lactams for Potential Administration through Portable Elastomeric Pumps (Home Therapy for Cystic Fibrosis Patients) and Motor-Operated Syringes (Intensive Care Units) Antimicrob. Agents Chemother., August 1, 2002; 46(8): 2327 - 2332. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. P. Howden and M. J. Richards The efficacy of continuous infusion flucloxacillin in home therapy for serious staphylococcal infections and cellulitis J. Antimicrob. Chemother., August 1, 2001; 48(2): 311 - 314. [Abstract] [Full Text] [PDF]
|
|