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, Duangchit Panomvana, Pintip Pongpech, Athavudhdeesomchok
Format: Journal
Published: 2018
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http://cmuir.cmu.ac.th/jspui/handle/6653943832/51981
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Institution: Chiang Mai University
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spelling th-cmuir.6653943832-519812018-09-04T06:13:26Z Pharmacodynamic target associated with clinical outcome of hospital-acquired pneumonia treatment with cefoperazone/sulbactam Narawadeeniamhun Duangchit Panomvana Pintip Pongpech Athavudhdeesomchok Pharmacology, Toxicology and Pharmaceutics 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. 2018-09-04T06:13:26Z 2018-09-04T06:13:26Z 2012-03-30 Journal 09751491 2-s2.0-84858971454 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84858971454&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/51981
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Pharmacology, Toxicology and Pharmaceutics
spellingShingle Pharmacology, Toxicology and Pharmaceutics
Narawadeeniamhun
Duangchit Panomvana
Pintip Pongpech
Athavudhdeesomchok
Pharmacodynamic target associated with clinical outcome of hospital-acquired pneumonia treatment with cefoperazone/sulbactam
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 Journal
author Narawadeeniamhun
Duangchit Panomvana
Pintip Pongpech
Athavudhdeesomchok
author_facet Narawadeeniamhun
Duangchit Panomvana
Pintip Pongpech
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 2018
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84858971454&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/51981
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