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High dose intermittent ticarcillin-clavulanate administration in pediatric cystic fibrosis patients

Jeffery T Zobell1, Krow Ampofo, Jared Cash

  • 1Pharmacy, Intermountain Primary Children's Medical Center, 100 North Mario Capecchi Drive, Salt Lake City, UT 84113, USA. Jeffery.zobell@imail.org

Journal of Cystic Fibrosis : Official Journal of the European Cystic Fibrosis Society
|May 18, 2010
PubMed

Insights

Higher doses of ticarcillin-clavulanate are safe for pediatric cystic fibrosis patients. This study found no significant adverse effects in patients receiving higher than recommended ticarcillin-clavulanate dosages.

Area of Science:

  • Pediatric pharmacology
  • Infectious disease management
  • Cystic Fibrosis therapeutics

Background:

  • The Intermountain Cystic Fibrosis Pediatric Center uses a ticarcillin-clavulanate dosing regimen higher than FDA and CFF guidelines.
  • This regimen involves 400mg/kg/day divided every 6 hours, with a maximum of 24g/day.

Purpose of the Study:

  • To evaluate the safety of the higher-than-recommended ticarcillin-clavulanate dosing regimen in pediatric cystic fibrosis patients.
  • To determine if this intensive dosing impacts key laboratory safety parameters.

Main Methods:

  • Retrospective analysis of pediatric cystic fibrosis patients (CF) admitted between January 1, 2005, and December 31, 2009.
  • Inclusion criteria required patients to receive the specified ticarcillin-clavulanate regimen for at least 7 days.
  • Collected and analyzed baseline and follow-up laboratory data, including liver function tests, white blood cell count, platelet count, and serum creatinine.

Main Results:

  • 127 pediatric CF patients met the study criteria.
  • Mean ticarcillin dose was 3.5g every 6 hours, totaling 13.5g daily.
  • No significant changes were observed in liver function tests, white blood cell count, or platelet count. Serum creatinine showed a statistically significant decrease.

Conclusions:

  • The higher-than-FDA-approved doses of ticarcillin-clavulanate demonstrate a safe profile for treating exacerbations in pediatric cystic fibrosis patients.
  • The observed decrease in serum creatinine warrants further investigation but did not indicate nephrotoxicity in this cohort.
Abstract

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