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Relationship between cefpirome clearance, serum creatinine, weight and age in patients treated for infection
M H Wilcox1, A Pithie, G Smith
1Department of Microbial Diseases, City Hospital, Nottingham, UK.
Abstract:
Cefpirome serum concentrations were measured by microbiological assay in 30 patients after five to nine days of treatment with 1 or 2 g bd for moderate to severe infection of presumed bacterial origin. Patients with serum creatinine (SCr) greater than 220 mumol/L were excluded. The age of patients ranged from 34-86 years. Creatinine clearance (Clcr) was calculated from age, sex, weight and SCr. The range of SCr was 63-220 mumol/L and the range of Clcr was 18-169 mL/min. The correlation coefficient with cefpirome clearance was 0.464 for SCr and 0.747 for Clcr. More than half of the patients with Clcr less than 50 mL/min had SCr within the normal range of 70-150 mumol/L. Mean cefpirome clearance in patients with Clcr 18-50 mL/min was 42.7 mL/min, which is very similar to the figure of 43.5 mL/min reported in a single dose volunteer study in patients with renal failure. Mean cefpirome clearance in patients with Clcr greater than 80 mL/min was 107.6 mL/min. In conclusion, these data on cefpirome clearance obtained after multiple dose treatment of patients with presumed bacterial infection are consistent with data previously obtained from single dose volunteer studies and support the currently recommended dose regimens. Clinicians should take account of age, weight and sex when estimating renal function from SCr.
Insights
Cefpirome clearance in patients with bacterial infections closely matches previous single-dose studies. Creatinine clearance (Clcr) is a better predictor than serum creatinine (SCr) for estimating cefpirome clearance in patients.
Area of Science:
- Pharmacokinetics
- Infectious Diseases
- Nephrology
Background:
- Cefpirome is an antibiotic used for bacterial infections.
- Renal function significantly impacts drug clearance.
- Accurate estimation of renal function is crucial for appropriate dosing.
Purpose of the Study:
- To evaluate cefpirome serum concentrations and clearance in patients with moderate to severe bacterial infections.
- To assess the correlation between cefpirome clearance and renal function parameters like serum creatinine (SCr) and creatinine clearance (Clcr).
- To validate existing cefpirome dosing regimens based on multiple-dose administration.
Main Methods:
- Microbiological assay was used to measure cefpirome serum concentrations in 30 patients.
- Patients received 1 or 2 g of cefpirome twice daily (bd).
- Creatinine clearance (Clcr) was calculated using age, sex, and serum creatinine (SCr); patients with SCr > 220 mumol/L were excluded.
Main Results:
- Cefpirome clearance showed a stronger correlation with Clcr (r=0.747) than with SCr (r=0.464).
- In patients with Clcr < 50 mL/min, over half had SCr within the normal range.
- Mean cefpirome clearance in patients with Clcr 18-50 mL/min was 42.7 mL/min, similar to single-dose studies.
Conclusions:
- Cefpirome clearance data from multiple-dose treatment in infected patients align with previous single-dose volunteer studies.
- The findings support current cefpirome dose recommendations.
- Clinicians should consider age, weight, and sex when estimating renal function from SCr to optimize cefpirome dosing.