Continuous infusion of ceftazidime with an elastomeric infusion device

Area of Science:

• Pharmacology
• Microbiology
• Drug Delivery Systems

Background:

• Ceftazidime is a crucial antibiotic for treating infections, particularly those caused by Pseudomonas aeruginosa.
• Optimizing ceftazidime delivery is essential for maintaining therapeutic efficacy.
• Elastomeric infusion devices offer a convenient method for continuous drug administration.

Purpose of the Study:

• To evaluate the serum pharmacokinetics of ceftazidime administered via continuous infusion using an elastomeric device.
• To assess the antimicrobial activity and stability of ceftazidime during continuous infusion.
• To determine if this delivery method maintains drug concentrations above the minimum inhibitory concentration (MIC) for Pseudomonas aeruginosa.

Main Methods:

• Twelve healthy volunteers received a ceftazidime bolus followed by a 24-hour continuous infusion via an elastomeric pump.
• Serum drug concentrations were measured using high-performance liquid chromatography (HPLC).
• Antimicrobial activity was assessed through minimum inhibitory concentrations (MICs), serum inhibitory titers (SITs), and serum bactericidal titers (SBTs).
• Ceftazidime stability was confirmed in the infusion devices, with ice packs used for insulation.

Main Results:

• Peak serum ceftazidime concentrations were observed 30 minutes post-bolus, with trough concentrations at 24 hours.
• The minimum inhibitory concentration (MIC) for Pseudomonas aeruginosa (1 microgram/mL) was exceeded 100% of the time.
• Median serum bactericidal titers (SBTs) demonstrated sustained activity against Pseudomonas aeruginosa throughout the infusion.
• Ceftazidime remained stable in the elastomeric infusion devices when insulated with ice packs.

Conclusions:

• A 500-mg bolus followed by a 3-g continuous infusion of ceftazidime over 24 hours using an elastomeric device achieves consistent therapeutic serum concentrations.
• This delivery method ensures sustained antimicrobial activity against Pseudomonas aeruginosa.
• Ceftazidime demonstrates adequate stability in elastomeric infusion devices when properly stored with ice packs, supporting its use in home healthcare settings.