Pharmacokinetics of cefuroxime in infants and neonates undergoing cardiac surgery.

British Journal of Clinical Pharmacology
Ralph GertlerKlaus Martin

Abstract

Very little data exist regarding the effect of cardiopulmonary bypass (CPB) on cefuroxime (CXM) pharmacokinetics in children less than one year of age. 50 mg kg-1 CXM i.v. after induction were followed by 75 mg kg-1 into the CPB circuit. In 42 patients undergoing cardiac surgery, 15-20 samples were obtained between 5 and 360 min after the first dose. Total CXM concentrations were measured by high-performance liquid chromatography and a pharmacokinetic/pharmacodynamic (PK/PD) modelling was performed. Using a fixed protein binding of 15.6% for CXM, peak plasma concentrations of unbound CXM were 229 ± 52 μg ml-1 after the first bolus and 341 ± 86 μg ml-1 on CPB. Nadir concentrations before CPB were 69 ± 20 μg ml-1 and six hours later decreased to 41 ± 19 μg ml-1 with and 24 ± 14 μg ml-1 without CPB. A two-compartment model was fitted with the main covariates body weight, CPB and postmenstrual age (PMA). PK parameters were as follows: systemic clearance, 5.15 [95% CI 4.5-5.8] l h-1 ; central volume of distribution, 11.25 [9.41-13.09] l; intercompartmental clearance, 18.19 [14.79-21.58] l h-1 ; and peripheral volume, 17.07 [15.7-18.5] L. ƒT > MIC of 32 μg ml-1 for an 8-h time period was between 70 and 100% (2.5-10 kg BW). According ...Continue Reading

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Citations

Dec 21, 2019·The Journal of Pharmacy and Pharmacology·Ulrich GergsJoachim Neumann
May 9, 2019·Seminars in Cardiothoracic and Vascular Anesthesia·Richard J Ing, Mark Twite
Oct 21, 2020·British Journal of Clinical Pharmacology·James N FullertonRobert Likic
Oct 7, 2020·Antimicrobial Agents and Chemotherapy·J LanoiseléeE Ollier

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