Intermittent and continuous ceftazidime infusion for critically ill trauma patients.
BACKGROUND
The adequacy of intermittent and continuous infusion ceftazidime for the treatment of nosocomial pneumonia in critically ill trauma patients was assessed by analyzing ceftazidime pharmacokinetics in relation to the minimum inhibitory concentration (MIC) and treatment outcome.


METHODS
Serial blood samples were obtained during ceftazidime therapy in 31 trauma patients. Ceftazidime pharmacokinetics were compared with that of previously studied healthy volunteers. Ceftazidime pharmacokinetics were analyzed according to the time above the MIC and treatment outcome.


RESULTS
Critically ill trauma patients had a significantly increased volume of distribution and clearance (0.32 +/- 0.14 L/kg and 2.35 +/- 0.89 mL. min(-1). kg(-1), respectively) compared with healthy volunteers (0.21 +/- 0.03 and 1.58 +/- 0.23 mL. min(-1). kg(-1)). The time above the MIC was >/=92% of the dosing interval for all patients and treatment outcomes were similar between the two treatment groups.


CONCLUSIONS
Ceftazidime pharmacokinetics are significantly altered in critically ill trauma patients. Both intermittent and continuous ceftazidime regimens were equally effective for the treatment of nosocomial pneumonia caused by less virulent bacteria.
Hanes
S D
SD
Department of Clinical Pharmacy, University of Tennessee, Memphis, Tennessee, USA.
Wood
G C
GC
Herring
V
V
Croce
M A
MA
Fabian
T C
TC
Pritchard
E
E
Boucher
B A
BA
D000293:Adolescent; D000328:Adult; D000368:Aged; D002442:Ceftazidime / Q000008:administration & dosage* / Q000493:pharmacokinetics; D002511:Cephalosporins / Q000008:administration & dosage / Q000493:pharmacokinetics; D016009:Chi-Square Distribution; D016638:Critical Illness; D003428:Cross Infection / Q000175:diagnosis / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006090:Gram-Negative Bacteria / Q000187:drug effects*; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000188:drug therapy*; D011336:Probability; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000382:microbiology*
D002511:Cephalosporins; D002442:Ceftazidime