scholarly journals PK/PD Target Attainment With Ceftolozane/Tazobactam Using Monte Carlo Simulation in Patients With Various Degrees of Renal Function, Including Augmented Renal Clearance and End-Stage Renal Disease

2016 ◽  
Vol 6 (1) ◽  
pp. 137-148 ◽  
Author(s):  
Alan J. Xiao ◽  
Luzelena Caro ◽  
Myra W. Popejoy ◽  
Jennifer A. Huntington ◽  
Ravina Kullar
Keyword(s):  
Monte Carlo Simulation ◽  
Monte Carlo ◽  
Renal Function ◽  
Renal Disease ◽  
Renal Clearance ◽  
End Stage Renal Disease ◽  
Target Attainment ◽  
Augmented Renal Clearance ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Simplified Aztreonam Dosing in Patients with End-Stage Renal Disease: Results of a Monte Carlo Simulation

2018 ◽  
Vol 62 (11) ◽  
Author(s):  
Alan E. Gross ◽  
Hongmei Xu ◽  
Diansong Zhou ◽  
Nidal Al-Huniti
Keyword(s):  
Monte Carlo Simulation ◽  
Monte Carlo ◽  
Renal Disease ◽  
Creatinine Clearance ◽  
End Stage Renal Disease ◽  
Target Attainment ◽  
Once Daily ◽  
Stage Renal Disease ◽  
End Stage

ABSTRACT The manufacturer-recommended aztreonam dosing for patients with creatinine clearance values of <10 ml/min/1.73 m2 is complex. It is not known whether simpler posthemodialysis dosing administered once daily or thrice weekly can reliably achieve pharmacodynamic goals. We found that 1 or 2 g administered once daily after hemodialysis had >90% probability of target attainment up to MICs of 4 or 8 mg/liter, respectively. Thrice-weekly dosing should generally be avoided, except in nonsevere infections with MICs of ≤0.5 mg/liter.

Pharmacokinetics of Intravenous and Intraperitoneal Cefotaxime in Patients Undergoing CAPD

1985 ◽  
Vol 5 (1) ◽  
pp. 33-35 ◽  
Author(s):  
Karel Matousovic ◽  
Josef Moravek Stefan ◽  
Vitko Vladimir Prat ◽  
Milena Horcickova
Keyword(s):  
Renal Function ◽  
Renal Insufficiency ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Peritoneal Membrane ◽  
Severe Renal Insufficiency ◽  
Elimination Half ◽  
Stage Renal Disease ◽  
End Stage ◽  
Dialysis Solutions

We investigated the pharmacokinetics of non-metabolized cefotaxime in 10 patients undergoing CAPD. The elimination half-life after IV administration of I g cefotaxime was 3.1 ± 1.3 hr, i.e. two to three times longer than in individuals with normal renal function but similar to patients with severe renal insufficiency. An average of 2.18% of the dose was recovered in the effluent. The halflife of I g cefotaxime administered in the dialysis solutions was 1.4 ± 0.8 hr. This difference between the half-lives after intraperitoneal and intravenous administration indicates a faster transport through the peritoneal membrane. Intraperitoneally administered cefotaxime -250 mg four times daily, was effective in the treatment of peritonitis in three CAPD patients. Since its introduction in 1976, CAPD has become an effective therapy for end-stage renal disease. The most serious complication is peritonitis and effective treatment is essential. Cefotaxime, a new broad-spectrurn cephalosporin, is active against most gramnegative and gram-positive organisms. It possesses no nephrotoxicity and may be useful in the treatment of peritonitis and other infections in patients on CAPD. This study was done to evaluate the pharmacokinetics of cefotaxime administered intravenously and intraperitoneally during CAPD.

Elective Surgery in Patients with End Stage Renal Disease: What's the Risk?

2009 ◽  
Vol 75 (9) ◽  
pp. 790-793 ◽  
Author(s):  
Christopher R. Schneider ◽  
William Cobb ◽  
Shivani Patel ◽  
David Cull ◽  
Cass Anna ◽  
...  
Keyword(s):  
Renal Function ◽  
Renal Disease ◽  
Surgical Procedures ◽  
General Surgery ◽  
Normal Renal Function ◽  
End Stage Renal Disease ◽  
Elective Surgical Procedures ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Little research has been performed in regards to the morbidity and outcomes associated with elective general surgery performed on patients with end stage renal disease (ESRD). With minimal data about the severity of disease in these patients, we sought to quantify the differences in the ESRD patient undergoing elective surgical procedures compared with matched controls. A review of all ESRD patients undergoing elective surgical procedures at a University Medical Center between 2001 and 2005 was performed. Outcomes included length of hospital stay, 1 year morbidity, and mortality. These patients were then compared with a control group with normal renal function matched 2:1. Fifty-two consecutive ESRD patients undergoing elective general surgery procedures were compared with 104 matched controls. The ESRD group experienced more complications (25 vs 16, P = 0.05) and had a larger number of overall complications compared with the controls (33 vs 19, P < 0.05). Length of stay was significantly longer in the ESRD group as well (8 vs 2.65 days, P < 0.0001). Incidence of death (4%) in the ESRD group was increased as well. Patients with ESRD require longer hospital stays and have an increased overall incidence and frequency of complications than patients with normal renal function undergoing elective general surgery procedures. The significantly increased morbidity should be considered when evaluating expected outcomes.

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