New PK/PD profile improvement following cephalosporin extended infusion : a systematic review

  • Melisa Rizky Nurani Departement of Clinical Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia
  • Widyati Widyati Widyati Faculty of Military Pharmacy, Indonesian Defense University, Bogor, 16180, Indonesia
  • Nanang Munif Yasin Departement of Clinical Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia

Abstract

Antimicrobial resistance is a global problem that is currently experienced in various countries, both developed and developing countries. The lack of discovery of new antibiotics and the increasing incidence of Multidrug–Resistant Organisms (MDROs) have sparked several efforts to optimize the administration of currently available antibiotics. Modifications in the pharmacokinetic and pharmacodynamic profiles are one of the strategies carried out, namely by extending the duration of infusion. Cephalosporins are time-dependent antibiotics; the longer they are exposed to an infusion, the more potent they are against bacteria. This is so that the drug concentration can remain above the MIC (Minimum Inhibitory Concentration) for an extended period of time throughout the infusion. In this study, articles available in Pubmed and Google Scholar from 2013-2023 using the PRISMA method related to the extension of the duration of cephalosporin infusion were evaluated. The search strategy used the keywords continuous infusion, extended infusion, prolong infusion, cefazolin, cefuroxime, ceftriaxone, ceftazidime, cefotaxime, and effectiveness. From the research results, it was found that continuous infusion was better able to achieve the desired target drug levels compared to intermittent infusion and IV bolus administration.

References

[1] P. Yang, Y. Chen, S. Jiang, P. Shen, X. Lu, and Y. Xiao, “Association between the rate of third generation cephalosporin-resistant Escherichia coli and Klebsiella pneumoniae and antibiotic consumption based on 143 Chinese tertiary hospitals data in 2014,” Eur J Clin Microbiol Infect Dis, vol. 39, no. 8, pp. 1495–1502, Aug. 2020, doi: 10.1007/s10096-020-03856-1.

[2] J. A. Roberts et al., “Continuous versus Intermittent β-Lactam Infusion in Severe Sepsis. A Meta-analysis of Individual Patient Data from Randomized Trials,” Am J Respir Crit Care Med, vol. 194, no. 6, pp. 681–691, Sep. 2016, doi: 10.1164/rccm.201601-0024OC.

[3] J. F. Prescott, “Beta‐lactam Antibiotics: Cephalosporins,” in Antimicrobial Therapy in Veterinary Medicine, 1st ed., S. Giguère, J. F. Prescott, and P. M. Dowling, Eds., Wiley, 2013, pp. 153–173. doi: 10.1002/9781118675014.ch9.

[4] E. Meyer, P. Gastmeier, M. Deja, and F. Schwab, “Antibiotic consumption and resistance: Data from Europe and Germany,” International Journal of Medical Microbiology, vol. 303, no. 6–7, pp. 388–395, Aug. 2013, doi: 10.1016/j.ijmm.2013.04.004.

[5] A. Lal, P. Jaoude, and A. A. El-Solh, “Prolonged versus Intermittent Infusion of β-Lactams for the Treatment of Nosocomial Pneumonia: A Meta-Analysis,” Infect Chemother, vol. 48, no. 2, p. 81, 2016, doi: 10.3947/ic.2016.48.2.81.

[6] G. Loeuille et al., “Stability Studies of 16 Antibiotics for Continuous Infusion in Intensive Care Units and for Performing Outpatient Parenteral Antimicrobial Therapy,” Antibiotics, vol. 11, no. 4, p. 458, Mar. 2022, doi: 10.3390/antibiotics11040458.

[7] J. Cousson et al., “Lung Concentrations of Ceftazidime Administered by Continuous versus Intermittent Infusion in Patients with Ventilator-Associated Pneumonia,” Antimicrob Agents Chemother, vol. 59, no. 4, pp. 1905–1909, Apr. 2015, doi: 10.1128/AAC.04232-14.

[8] B. I. Naik et al., “Comparative total and unbound pharmacokinetics of cefazolin administered by bolus versus continuous infusion in patients undergoing major surgery: a randomized controlled trial,” British Journal of Anaesthesia, vol. 118, no. 6, pp. 876–882, Jun. 2017, doi: 10.1093/bja/aex026.

[9] K. Skhirtladze‐Dworschak et al., “Cefuroxime plasma and tissue concentrations in patients undergoing elective cardiac surgery: Continuous vs bolus application. A pilot study,” British Journal of Clinical Pharmacology, 2019, doi: 10.1111/bcp.13865.

[10] H. Aardema et al., “Continuous versus intermittent infusion of cefotaxime in critically ill patients: a randomized controlled trial comparing plasma concentrations,” Journal of Antimicrobial Chemotherapy, p. dkz463, Nov. 2019, doi: 10.1093/jac/dkz463.

[11] E. Leegwater, B. V. C. Kraaijenbrink, D. J. A. R. Moes, I. M. Purmer, and E. B. Wilms, “Population pharmacokinetics of ceftriaxone administered as continuous or intermittent infusion in critically ill patients,” Journal of Antimicrobial Chemotherapy, vol. 75, no. 6, pp. 1554–1558, Jun. 2020, doi: 10.1093/jac/dkaa067.
Published
2024-10-31
How to Cite
NURANI, Melisa Rizky; WIDYATI, Widyati Widyati; YASIN, Nanang Munif. New PK/PD profile improvement following cephalosporin extended infusion : a systematic review. JURNAL ILMU KEFARMASIAN INDONESIA, [S.l.], v. 22, n. 2, p. 234-240, oct. 2024. ISSN 2614-6495. Available at: <http://jifi.farmasi.univpancasila.ac.id/index.php/jifi/article/view/1583>. Date accessed: 05 nov. 2024. doi: https://doi.org/10.35814/jifi.v22i2.1583.