Academic Journal
Steering away from current amoxicillin dose reductions in hospitalized patients with impaired kidney function to avoid subtherapeutic drug exposure
| العنوان: | Steering away from current amoxicillin dose reductions in hospitalized patients with impaired kidney function to avoid subtherapeutic drug exposure |
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| المؤلفون: | Smit, C., Sen, S., von Dach, E., Karmime, A., Lescuyer, P., Tonoli, D., Bielicki, J., Huttner, A., Pfister, M. |
| سنة النشر: | 2022 |
| المجموعة: | University of Basel: edoc |
| الوصف: | Current dose reductions recommended for amoxicillin in patients with impaired kidney function could lead to suboptimal treatments. In a prospective, observational study in hospitalized adults with varying kidney function treated with an IV or oral dose of amoxicillin, amoxicillin concentrations were measured in 1-2 samples on the second day of treatment. Pharmacometric modelling and simulations were performed to evaluate the probability of target attainment (PTA) for 40% of the time above MIC following standard (1000 mg q6h), reduced or increased IV dosing strategies. A total of 210 amoxicillin samples was collected from 155 patients with kidney function based on a CKD-EPI of between 12 and 165 mL/min/1.73 m(2). Amoxicillin clearance could be well predicted with body weight and CKD-EPI. Recommended dose adjustments resulted in a clinically relevant reduction in the PTA for the nonspecies-related PK/PD breakpoint MIC of 8 mg/L (92%, 62% and 38% with a CKD-EPI of 10, 20 and 30 mL/min/1.73 m(2), respectively, versus 100% for the standard dose). For MICs 90% was reached in these patients following both reduced and standard dose regimens. Our study showed that for amoxicillin, recommended dose reductions with impaired kidney function could lead to subtherapeutic amoxicillin concentrations in hospitalized patients, especially when targeting less susceptible pathogens. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 2079-6382 |
| Relation: | https://edoc.unibas.ch/90831/1/20221201152004_6388b81456380.pdf; Smit, C. and Sen, S. and von Dach, E. and Karmime, A. and Lescuyer, P. and Tonoli, D. and Bielicki, J. and Huttner, A. and Pfister, M. (2022) Steering away from current amoxicillin dose reductions in hospitalized patients with impaired kidney function to avoid subtherapeutic drug exposure. Antibiotics (Basel), 11 (9). p. 1190.; info:pmid/36139969; urn:ISSN:2079-6382 (Print)2079-6382 (Linking) |
| DOI: | 10.3390/antibiotics11091190 |
| الاتاحة: | https://edoc.unibas.ch/90831/ https://edoc.unibas.ch/90831/1/20221201152004_6388b81456380.pdf https://doi.org/10.3390/antibiotics11091190 |
| Rights: | cc_by ; info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.4B78A5B6 |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 20796382 |
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| DOI: | 10.3390/antibiotics11091190 |