A case of recovery from aphasia following dose reduction of cefepime by bayesian prediction-based therapeutic drug monitoring

Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy
Kazutaka OdaHideyuki Saito

Abstract

Cefepime is known to exert bactericidal activity against Pseudomonas aeruginosa. Cefepime-induced neurotoxicity, most likely caused by increased exposure, has recently become a major concern in clinical practice; therefore, appropriate dose reduction of cefepime should be applied with respect to patients with low cefepime clearance (mostly eliminated by the kidneys). Here, we report a case in which Bayesian prediction-based therapeutic drug monitoring (Bayes-TDM) was effectively used to reduce the dose of cefepime in a patient with pneumonia to prevent neurotoxic complications. A woman (age: 59 years, body weight: 32.5 kg, serum creatinine concentration: 1.02 mg/dL) developed pneumonia caused by P. aeruginosa while receiving treatment for scleroderma and systemic lupus erythematosus. She started treatment with a dosing regimen of 1.0 g of cefepime every 8 h (day X). On day X+5, aphasia developed, and the serum cefepime concentration was 71.3 mg/L at trough. This concentration was twice or thrice higher than the reported safe concentration of cefepime (22 or 35 mg/L at trough). Therefore, we reduced the dose of cefepime to 0.5 g every 12 h using Bayes-TDM from day X+7. As a result, the severity of aphasia decreased by day X+10, ...Continue Reading

Citations

Jul 4, 2020·Therapeutic Drug Monitoring·Xavier EngalencJean-Baptiste Woillard
Mar 6, 2021·Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy·Mohammad H Al-Shaer, Charles A Peloquin

❮ Previous
Next ❯

Related Concepts

Related Feeds

Aphasia

Aphasia affects the ability to process language, including formulation and comprehension of language and speech, as well as the ability to read or write. Here is the latest research on aphasia.

Related Papers

The Lancet Infectious Diseases
Jeroen MebisZwi Nisan Berneman
Journal of Pharmacology & Pharmacotherapeutics
Mossad Gamaleddin Ahmed ElsayedMohamed Elbadawy
Enfermedades infecciosas y microbiología clínica
J A García-Rodríguez
The Lancet Infectious Diseases
Trent G TowneKelly Echevarria
Expert Opinion on Drug Safety
Lorenzo Drago, Elena De Vecchi
© 2021 Meta ULC. All rights reserved