Comparable Effect of Two-Step Versus Extended Infusions on the Pharmacokinetics of Imipenem in Patients with Sepsis and
- PDF / 511,191 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 52 Downloads / 120 Views
ORIGINAL RESEARCH
Comparable Effect of Two-Step Versus Extended Infusions on the Pharmacokinetics of Imipenem in Patients with Sepsis and Septic Shock Yingzi Huang . Kang Xu . Ying Zhan . Xian Zha . Songqiao Liu . Jianfeng Xie . Lin Liu . Qing Li . Hua Shao . Yi Yang
Received: August 19, 2019 Ó Springer Healthcare Ltd., part of Springer Nature 2020
ABSTRACT Introduction: The present study aimed to compare the pharmacokinetic/pharmacodynamic (PK/PD) parameters of imipenem administered by two-step (50% delivered in a 30-min bolus, 50% for the following 90 min) or extended (administered continuously for 2 h) infusion. Methods: Patients with sepsis and septic shock were prospectively enrolled and randomized into four groups. Subjects in the two-step or Enhanced Digital Features To view enhanced digital features for this article go to https://doi.org/10.6084/ m9.figshare.11591781. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12325020-01339-5) contains supplementary material, which is available to authorized users. Y. Huang S. Liu J. Xie L. Liu Q. Li Y. Yang (&) Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China e-mail: [email protected] K. Xu Pharmacy Department, Hospital for Skin Diseases, Chinese Academy of Medical Sciences, Nanjing, China Y. Zhan X. Zha H. Shao Pharmacy Department, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
extended groups were given two doses of imipenem (0.5 g q6h and 1.0 g q8h). The plasma imipenem concentrations were measured at given time points after the fifth dose. The PK/ PD target was defined as the achievement of a fractional time above the minimal inhibitory concentration (MIC) of [ 40%. Results: Thirty-five patients were eventually enrolled. No significant difference was observed in the percentage of patients achieving 40% T [ MIC between the different infusion modes with the same dosage, although the two-step groups exhibited a significantly shorter Tmax compared with the extended groups (0.5 g q6h: 1.5 ± 0.8 vs. 2.0 ± 0.0 h; 1.0 g q8h: 1.0 ± 0.6 vs. 2.0 ± 0.0 h; both, p \ 0.05). All four groups achieved 40% T [ MIC when MIC was 0.5–4.0 lg/ml, but only regimens with a higher dose (1.0 g q8h) achieved target when MIC was 8 lg/ml. Conclusion: The two-step and extended regimens of imipenem are comparable to the PK/PD target in the treatment of sepsis and septic shock. A higher dose (1.0 g q8h) should be considered for target achievement at an MIC of [ 8 lg/ml. Trial Registration: ClinicalTrials.gov identifier, NCT02616354. Keywords: Imipenem; Infectious disease; Infusion mode; Minimal inhibitory concentration; Pharmacokinetic/ pharmacodynamic; Sepsis
Adv Ther
Key Summary Points The present study is an exploratory prospective study that attempted to address a practical question: whether the efficacy of imipenem could be improved by the two-step infusion mode instead of the traditional extended infusion mode. The differences in
Data Loading...
