High dose intermittent ticarcillin-clavulanate administration in pediatric cystic fibrosis patients.
BACKGROUND
The Intermountain Cystic Fibrosis Pediatric Center utilizes ticarcillin-clavulanate 400mg/kg/day divided every 6h, (maximum 24 g/day). This dosing strategy is higher than the Cystic Fibrosis Foundation (CFF) recommendations and the Food and Drug Administration (FDA) approved package labeling. The purpose is to determine the safety of this dosing regimen.


METHODS
A retrospective study of pediatric cystic fibrosis (CF) patients admitted from January 1, 2005 to December 31, 2009 who received the dosing regimen for at least 7 days. Baseline and follow-up laboratory parameters were recorded. Statistical analysis was performed.


RESULTS
127 patients met inclusion criteria. The mean (+ or - SD) ticarcillin dose was 3.5 g (+ or - 2.16) every 6 h; while the mean (+ or - SD) total ticarcillin dose was 13.5 g (+ or - 6.5) per day. No significant differences occurred in liver function tests, white blood count, and platelet count from baseline. Serum creatinine showed a statistically significant decrease from baseline.


CONCLUSIONS
Higher than FDA approved doses of ticarcillin-clavulanate may be safely used in the treatment of exacerbations in pediatric cystic fibrosis patients.
Zobell
Jeffery T
JT
Pharmacy, Intermountain Primary Children's Medical Center, 100 North Mario Capecchi Drive, Salt Lake City, UT 84113, USA. Jeffery.zobell@imail.org
Ampofo
Krow
K
Cash
Jared
J
Korgenski
Kent
K
Chatfield
Barbara A
BA
D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D002969:Clavulanic Acids / Q000008:administration & dosage / Q000009:adverse effects; D003404:Creatinine; D003550:Cystic Fibrosis / Q000188:drug therapy*; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D017277:Drug Approval; D006801:Humans; D007223:Infant; D007958:Leukocyte Count; D008111:Liver Function Tests; D010976:Platelet Count; D012189:Retrospective Studies; D013982:Ticarcillin / Q000008:administration & dosage / Q000009:adverse effects
D000900:Anti-Bacterial Agents; D002969:Clavulanic Acids; C043215:ticarcillin-clavulanic acid; D003404:Creatinine; D013982:Ticarcillin