title: Optimizing beta-lactam pharmacodynamics against Pseudomonas aeruginosa in adult cystic fibrosis patients.
abstract: Patients with cystic fibrosis (CF) exhibit increased clearance of beta-lactams. The purpose of this study was to predict the probability of beta-lactam target attainment (PTA) against Pseudomonas aeruginosa in adult CF patients based on local microbiological data.
  
  
  
  CF-specific pharmacokinetic parameters were obtained from published data for aztreonam, cefepime, ceftazidime, meropenem and piperacillin-tazobactam. Pharmacodynamic modeling was used to determine the PTA for bolus, prolonged infusion, and continuous infusion regimens.
  
  
  
  Prolonged infusion of meropenem 2g every 8h performed the best among all regimens tested, with a PTA of 83%. The PTA was increased with both prolonged and continuous infusion; however, no regimen reached the target PTA of >90% against P. aeruginosa in CF patients at our institution.
  
  
  
  Prolonged and continuous infusion provided higher PTA than bolus for all regimens. Further investigation of novel regimens in CF patients is needed.
authors.affiliation: University of Kentucky HealthCare, Lexington, KY 40508, United States; University of Kentucky College of Pharmacy, Lexington, KY 40536,United States.
authors.forename: R Zachary
authors.initials: RZ
authors.lastname: Thompson
authors.affiliation: University of Kentucky HealthCare, Lexington, KY 40508, United States; University of Kentucky College of Pharmacy, Lexington, KY 40536,United States.
authors.forename: Craig A
authors.initials: CA
authors.lastname: Martin
authors.affiliation: University of Kentucky HealthCare, Lexington, KY 40508, United States; University of Kentucky College of Pharmacy, Lexington, KY 40536,United States.
authors.forename: Donna R
authors.initials: DR
authors.lastname: Burgess
authors.affiliation: University of Kentucky HealthCare, Lexington, KY 40508, United States; University of Kentucky College of Pharmacy, Lexington, KY 40536,United States.
authors.forename: W Cliff
authors.initials: WC
authors.lastname: Rutter
authors.affiliation: University of Kentucky College of Pharmacy, Lexington, KY 40536,United States. Electronic address: david.burgess@uky.edu.
authors.forename: David S
authors.initials: DS
authors.lastname: Burgess
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000145:classification / Q000493:pharmacokinetics; D003550:Cystic Fibrosis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D004333:Drug Administration Routes; D005260:Female; D006801:Humans; D008297:Male; D008657:Metabolic Clearance Rate; D008826:Microbial Sensitivity Tests / Q000379:methods; D008962:Models, Theoretical; D011552:Pseudomonas Infections / Q000175:diagnosis / Q000188:drug therapy*; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000302:isolation & purification; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D047090:beta-Lactams / Q000008:administration & dosage / Q000145:classification / Q000493:pharmacokinetics
chemical_list: D000900:Anti-Bacterial Agents; D047090:beta-Lactams
keywords: Beta-lactam; Continuous-infusion; Pharmacodynamics; Pharmacokinetics; Prolonged infusion; Pseudomonas aeruginosa