Plasma and lung concentrations of ceftazidime administered in continuous infusion to critically ill patients with severe nosocomial pneumonia.
OBJECTIVE
To determine the steady-state plasma and epithelial lining fluid (ELF) concentrations of ceftazidime administered in continuous infusion to critically ill patients with severe nosocomial pneumonia.


METHODS
Prospective, open-label study.


METHODS
An intensive care unit and research ward in a university hospital.


METHODS
A total of 15 adult patients with severe nosocomial bacterial pneumonia on mechanical ventilation were enrolled.


METHODS
All subjects received a 30 min intravenous infusion of 2 g ceftazidime followed by a continuous infusion of 4 g over 24 h. The concentrations of ceftazidime in plasma and ELF were determined at steady-state after 2 days of therapy by high performance liquid chromatography.


RESULTS
The mean +/-SD steady-state plasma and ELF concentrations of 4 g ceftazidime in continuous infusion were 39.6+/-15.2 microg/mL and 8.2+/-4.8 microg/mL, respectively, showing a mean +/-SD percentage penetration of ceftazidime into ELF of 20.6+/-8.9%.


CONCLUSIONS
The administration of 4 g ceftazidime in continuous infusion in critically ill patients with severe nosocomial pneumonia provides concentrations in excess of the minimal inhibitory concentration of many susceptible organisms over the course of therapy both in serum and ELF. However, for some pathogens such as P. aeruginosa, higher doses of ceftazidime should be administered, or another agent should be used in combination.
Boselli
Emmanuel
E
Department of Anesthesiology and Intensive Care, Hôtel-Dieu, 1 Place de l'Hôpital, 69288 Lyon cedex 02, France. emmanuel.boselli@chu-lyon.fr
Breilh
Dominique
D
Rimmelé
Thomas
T
Poupelin
Jean-Charles
JC
Saux
Marie-Claude
MC
Chassard
Dominique
D
Allaouchiche
Bernard
B
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D002442:Ceftazidime / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D003428:Cross Infection / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008168:Lung / Q000737:chemistry*; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000188:drug therapy* / Q000209:etiology; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000009:adverse effects*
D000900:Anti-Bacterial Agents; D002442:Ceftazidime