Pharmacodynamic target associated with clinical outcome of hospital-acquired pneumonia treatment with cefoperazone/sulbactam

Background: For anti-infective agents, pharmacodynamics (PD) parameters have been proposed as predictors of clinical and microbiological success. Hospital-Acquired Pneumonia (HAP) patients have altered pharmacokinetics (PK) that needs to be considered when dosing antibiotics. We conducted a prospect...

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Main Authors: Narawadeeniamhun, Panomvana D., Pongpech P., Athavudhdeesomchok
Format: Article
Language:English
Published: 2014
Online Access:http://www.scopus.com/inward/record.url?eid=2-s2.0-84858971454&partnerID=40&md5=0456deb2bb4ea23bca355553be5788b1
http://cmuir.cmu.ac.th/handle/6653943832/3920
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spelling th-cmuir.6653943832-39202014-08-30T02:35:28Z Pharmacodynamic target associated with clinical outcome of hospital-acquired pneumonia treatment with cefoperazone/sulbactam Narawadeeniamhun Panomvana D. Pongpech P. Athavudhdeesomchok Background: For anti-infective agents, pharmacodynamics (PD) parameters have been proposed as predictors of clinical and microbiological success. Hospital-Acquired Pneumonia (HAP) patients have altered pharmacokinetics (PK) that needs to be considered when dosing antibiotics. We conducted a prospective study to assess (PK/PD) of cefoperazone/sulbactam treatment in HAP patients and to identify patient and PD indices associated with clinical response. Methods: Patients with HAP were identified, and information related to patient demographics, clinical status, antibiotic treatment and clinical outcome were documented. Cefoperazone/Sulbactam plasma concentrations were analyzed by validated High-Performance Liquid Chromatography (HPLC).Patient characteristics and PK/PD related factors were tested for associations with clinical outcome. Results: Twenty eight patients of hospital-acquired pneumonia patients were identified. 26 patients (93.1%) had Acinetobacterbaumannii infection and 2 patients (6.9%) had both of Pseudomonas aeruginosa and Acinetobacterbaumannii infection. At the end of treatment, clinical cure was note in 25 % of patients (7/28), improvement 46.4% (13/28) and 28.5% (8/28) had clinical failure. For microbiology outcome, microbiological eradication was note in 12 /28 (42.9%), 12/28 (42.9%) patients had organism persistence and 4 (14.3%) patients had new infection organism.The time which total cefoperazone concentration exceed the MIC (50% T>MIC) and age of the patient who was less than 60 years were significantly associated with clinical response (p<0.05) Conclusion: The percent of a dosing interval in which thecefoperazone serum concentration is above the MIC (%T>MIC) is strongly associated with clinical outcomeand is essential to the appropriate management of A.baumanii and P.aeruginosa infections. 2014-08-30T02:35:28Z 2014-08-30T02:35:28Z 2012 Article 9751491 http://www.scopus.com/inward/record.url?eid=2-s2.0-84858971454&partnerID=40&md5=0456deb2bb4ea23bca355553be5788b1 http://cmuir.cmu.ac.th/handle/6653943832/3920 English
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
language English
description Background: For anti-infective agents, pharmacodynamics (PD) parameters have been proposed as predictors of clinical and microbiological success. Hospital-Acquired Pneumonia (HAP) patients have altered pharmacokinetics (PK) that needs to be considered when dosing antibiotics. We conducted a prospective study to assess (PK/PD) of cefoperazone/sulbactam treatment in HAP patients and to identify patient and PD indices associated with clinical response. Methods: Patients with HAP were identified, and information related to patient demographics, clinical status, antibiotic treatment and clinical outcome were documented. Cefoperazone/Sulbactam plasma concentrations were analyzed by validated High-Performance Liquid Chromatography (HPLC).Patient characteristics and PK/PD related factors were tested for associations with clinical outcome. Results: Twenty eight patients of hospital-acquired pneumonia patients were identified. 26 patients (93.1%) had Acinetobacterbaumannii infection and 2 patients (6.9%) had both of Pseudomonas aeruginosa and Acinetobacterbaumannii infection. At the end of treatment, clinical cure was note in 25 % of patients (7/28), improvement 46.4% (13/28) and 28.5% (8/28) had clinical failure. For microbiology outcome, microbiological eradication was note in 12 /28 (42.9%), 12/28 (42.9%) patients had organism persistence and 4 (14.3%) patients had new infection organism.The time which total cefoperazone concentration exceed the MIC (50% T>MIC) and age of the patient who was less than 60 years were significantly associated with clinical response (p<0.05) Conclusion: The percent of a dosing interval in which thecefoperazone serum concentration is above the MIC (%T>MIC) is strongly associated with clinical outcomeand is essential to the appropriate management of A.baumanii and P.aeruginosa infections.
format Article
author Narawadeeniamhun
Panomvana D.
Pongpech P.
Athavudhdeesomchok
spellingShingle Narawadeeniamhun
Panomvana D.
Pongpech P.
Athavudhdeesomchok
Pharmacodynamic target associated with clinical outcome of hospital-acquired pneumonia treatment with cefoperazone/sulbactam
author_facet Narawadeeniamhun
Panomvana D.
Pongpech P.
Athavudhdeesomchok
author_sort Narawadeeniamhun
title Pharmacodynamic target associated with clinical outcome of hospital-acquired pneumonia treatment with cefoperazone/sulbactam
title_short Pharmacodynamic target associated with clinical outcome of hospital-acquired pneumonia treatment with cefoperazone/sulbactam
title_full Pharmacodynamic target associated with clinical outcome of hospital-acquired pneumonia treatment with cefoperazone/sulbactam
title_fullStr Pharmacodynamic target associated with clinical outcome of hospital-acquired pneumonia treatment with cefoperazone/sulbactam
title_full_unstemmed Pharmacodynamic target associated with clinical outcome of hospital-acquired pneumonia treatment with cefoperazone/sulbactam
title_sort pharmacodynamic target associated with clinical outcome of hospital-acquired pneumonia treatment with cefoperazone/sulbactam
publishDate 2014
url http://www.scopus.com/inward/record.url?eid=2-s2.0-84858971454&partnerID=40&md5=0456deb2bb4ea23bca355553be5788b1
http://cmuir.cmu.ac.th/handle/6653943832/3920
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