Target-Controlled Infusion of Cefepime in Critically Ill Patients

Antimicrobial Agents and Chemotherapy
Stijn JonckheerePieter J Colin


Attainment of appropriate pharmacokinetic-pharmacodynamic (PK-PD) targets for antimicrobial treatment is challenging in critically ill patients, particularly for cefepime, which exhibits a relative narrow therapeutic-toxic window compared to other beta-lactam antibiotics. Target-controlled infusion (TCI) systems, which deliver drugs to achieve specific target drug concentrations, have successfully been implemented for improved dosing of sedatives and analgesics in anesthesia. We conducted a clinical trial in an intensive care unit (ICU) to investigate the performance of TCI for adequate target attainment of cefepime. Twenty-one patients treated with cefepime according to the standard of care were included. Cefepime was administered through continuous infusion using TCI for a median duration of 4.5 days. TCI was based on a previously developed population PK model incorporating the estimated creatinine clearance based on the Cockcroft-Gault formula as the input variable to calculate cefepime clearance. A cefepime blood concentration of 16 mg/liter was targeted. To evaluate the measured versus predicted plasma concentrations, blood samples were taken (median of 10 samples per patient), and total cefepime concentrations were measur...Continue Reading

Associated Clinical Trials

Feb 23, 2016·Stijn Jonckheere


Feb 1, 1992·Journal of Pharmacokinetics and Biopharmaceutics·J R VarvelS L Shafer
Sep 3, 2002·The Journal of Antimicrobial Chemotherapy·Vincent H TamGeorge L Drusano
Dec 15, 2010·Clinical Pharmacokinetics·Marta UlldemolinsJeffrey Lipman
Oct 28, 2011·BMC Medical Research Methodology·Guy N BrockJohn Myers
Sep 14, 2013·Critical Care : the Official Journal of the Critical Care Forum·Jason PhuaAmartya Mukhopadhyay
Jan 17, 2014·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Jason A RobertsUNKNOWN DALI Study
Jan 21, 2014·The Journal of Antimicrobial Chemotherapy·Gloria WongJason A Roberts
Jul 15, 2015·The Journal of Antimicrobial Chemotherapy·Alexis TabahUNKNOWN Working Group for Antimicrobial Use in the ICU within the Infection Section of the European Society of Intensive Care Medici
Oct 31, 2015·Anesthesia and Analgesia·Michel M R F StruysThomas W Schnider
Jun 2, 2016·The Journal of Antimicrobial Chemotherapy·Stijn JonckheerePieter Colin
Jan 24, 2017·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·T HuwylerA Huttner
Feb 6, 2017·The Journal of Antimicrobial Chemotherapy·Vincent H TamRafael Cantón
Oct 31, 2017·Therapeutic Drug Monitoring·Tõnis TasaIrja Lutsar
Nov 16, 2017·Critical Care : the Official Journal of the Critical Care Forum·Lauren E PayneGilles L Fraser
Dec 7, 2017·The Journal of Antimicrobial Chemotherapy·T M RawsonA H Holmes
Sep 25, 2018·Critical Care : the Official Journal of the Critical Care Forum·Rui Pedro Veiga, José-Artur Paiva

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