ArticleAntimicrobial agents and chemotherapy2014
How to minimize toxic exposure to pyridine during continuous infusion of ceftazidime in patients with cystic fibrosis?
Article in Antimicrobial agents and chemotherapy, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- Systematic review of stability data pertaining to selected antibiotics used for extended infusions in outpatient parenteral antimicrobial therapy (OPAT) at standard room temperature and in warmer climates.European journal of hospital pharmacy : science and practice · 2020Pooled it
- Solving the degradation problem of continuous ceftazidime infusions-the Cooltaz study.Antimicrobial agents and chemotherapy · 2026Article
- Breakthrough RP-HPLC strategy for synchronous analysis of pyridine and its degradation products in powder for injection using quality metrics.Scientific reports · 2026Article
- Stability of Two Reserve Antibiotics in Elastomeric Pumps: Ceftazidime-Avibactam and Ceftolozane-Tazobactam.Antibiotics (Basel, Switzerland) · 2025Article
- The Infusion of Piperacillin/Tazobactam with an Elastomeric Device: A Combined 24-H Stability Study and Drug Solution Flow Rate Analysis.Pharmaceuticals (Basel, Switzerland) · 2024Article
- Evaluation of the stability of ceftazidime/avibactam in elastomeric infusion devices used for outpatient parenteral antimicrobial therapy utilizing a national stability protocol framework.JAC-antimicrobial resistance · 2024Article
- Stability and compatibility of antibiotics in peritoneal dialysis solutions.Clinical kidney journal · 2022Review
- A Review of Extended and Continuous Infusion Beta-Lactams in Pediatric Patients.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2022Article
- Outpatient Parenteral Antimicrobial Therapy in Children.Current infectious disease reports · 2019Review
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Authors and funding
14 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Ceftazidime is particularly efficient against Pseudomonas aeruginosa in cystic fibrosis patients. Thus, the spontaneous production of pyridine, which is a toxic product, raises some concern. Our aim was to examine the kinetics of degradation of ceftazidime in portable infusion pumps either at 4°C, 22°C, or 33°C and to propose some recommendations in order to reduce the pyridine exposure. Two administration models were studied in vitro. In model 1, we administered 12 g of ceftazidime infused over 23 h (once-daily infusion) compared to 6 g infused over 11.5 h in model 2 (twice-daily regimen). Samples were collected at 0 h and then every 4 and 2 h after the shaping of portable infusion pumps in models 1 and 2, respectively. Both ceftazidime and pyridine were analyzed using an ultraviolet high-performance liquid chromatograph. Production of pyridine is highly depending on the temperature. The in situ production of pyridine per day of treatment decreases at a ratio close to 1/6 and 1/3 between 33°C and 4°C in models 1 and 2, respectively. Regardless of the conditions, the production of pyridine is significantly lower in model 2, whereas the total delivery amount of ceftazidime is significantly higher at 4°C and 33°C compared to that in model 1. According to a the precautionary principle, these findings lead to three major recommendations: (i) exposing a solution of ceftazidime to over 22°C should be strictly avoided, (ii) a divided dose of 6 g over 11.5 h instead of a once-daily administration is preferred, and (iii) infusion should be administered immediately after reconstitution.
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