Article ; Online: Ceftazidime Plasma Concentrations and Neurotoxicity: The Importance of Therapeutic Drug Monitoring in Patients Undergoing Different Modalities of Renal Replacement Therapy. A Grand Round.
2023 Volume 45, Issue 6, Page(s) 711–713
Abstract: Abstract: Ceftazidime-avibactam (CTZ-AVM) is a novel cephalosporin/beta-lactamase inhibitor with broad-spectrum activity against multidrug-resistant Pseudomonas aeruginosa . Ceftazidime-induced neurotoxicity is a well-described adverse effect, ... ...
Abstract | Abstract: Ceftazidime-avibactam (CTZ-AVM) is a novel cephalosporin/beta-lactamase inhibitor with broad-spectrum activity against multidrug-resistant Pseudomonas aeruginosa . Ceftazidime-induced neurotoxicity is a well-described adverse effect, particularly in patients with renal insufficiency. However, appropriate dosing of ceftazidime-avibactam in patients undergoing renal replacement therapy (RRT) is sparsely investigated, and therapeutic drug monitoring to guide dosing remains lacking. Furthermore, when dose adjustment for impaired renal function is based on CTZ-AVM product information, inferior cure rates have been obtained compared with those with the standard therapy for intra-abdominal infections. Maintaining an effective dose while avoiding toxicity in these patients is challenging. Here, the authors describe the case of a critically ill patient, undergoing 2 modalities of RRT, who developed ceftazidime-induced neurotoxicity as confirmed using ceftazidime therapeutic drug monitoring. This case illustrates a therapeutic drug monitoring-based approach for guiding ceftazidime-avibactam dosing in this context and in diagnosing the cause of neurological symptoms and signs. |
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MeSH term(s) | Humans ; Anti-Bacterial Agents/adverse effects ; Ceftazidime/therapeutic use ; Continuous Renal Replacement Therapy ; Drug Combinations ; Drug Monitoring ; Microbial Sensitivity Tests ; Teaching Rounds |
Chemical Substances | Anti-Bacterial Agents ; Ceftazidime (9M416Z9QNR) ; Drug Combinations |
Language | English |
Publishing date | 2023-07-03 |
Publishing country | United States |
Document type | Case Reports ; Journal Article |
ZDB-ID | 424443-6 |
ISSN | 1536-3694 ; 0163-4356 |
ISSN (online) | 1536-3694 |
ISSN | 0163-4356 |
DOI | 10.1097/FTD.0000000000001124 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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