Evidence map›Paper›PMID 29908155›Full record

ArticleChest2018

Pharmacokinetics of Continuous Infusion Beta-lactams in the Treatment of Acute Pulmonary Exacerbations in Adult Patients With Cystic Fibrosis.

Lisa T Hong, Theodore G Liou, Rishi Deka, Jordan B King, Vanessa Stevens, David C Young

Open access · bronzeAbstract read
In one paragraph

Article in Chest, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
1.5field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 22 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Review
  5. Article
  6. Ceftolozane/tazobactam for Pseudomonas aeruginosa pulmonary exacerbations in cystic fibrosis adult patients: a case series.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2021
    Article
  7. Review
  8. Review
  9. The Clinician Scientist.The Canadian journal of hospital pharmacy · 2021
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 5 institutions in 1 country.

Lisa T HongLoma Linda University School of Pharmacy, Loma Linda, CA. Electronic address: lhong@llu.edu.
Theodore G LiouUniversity of Utah School of Medicine, Salt Lake City, UT.
Rishi DekaDepartment of Radiation Medicine and Applied Sciences, University of California San Diego, San Diego, CA.
Jordan B KingKaiser Permanente Colorado, Aurora, CO.
Vanessa StevensUniversity of Utah School of Medicine, Salt Lake City, UT.
David C YoungUniversity of Utah College of Pharmacy, Salt Lake City, UT; University of Utah Health Care, Salt Lake City, UT.
University of Utah · USKaiser Permanente · USLoma Linda University · USUniversity of California, San Diego · USUniversity of Utah Health Care · US

Funding

Quality of Life in Advanced CF in a Transplantation EraR01HL072938 · NHLBI · EDUCATION DEVELOPMENT CENTER, INC. · PI ROBINSON, WALTER M · 2003 to 2007
$3.0M
Explanatory models of CF Survival, Infection and Intermediate Clinical OutcomesR01HL125520 · NHLBI · UNIVERSITY OF UTAH · PI LIOU, THEODORE GEH-LU · 2015 to 2018
$1.4M
Polymicrobial disease and inflammation in cystic fibrosisR21HL084341 · NHLBI · UNIVERSITY OF UTAH · PI LIOU, THEODORE GEH-LU · 2007 to 2008
$411k
NHLBI NIH HHS R01 HL072938NHLBI NIH HHS R01 HL125520NHLBI NIH HHS R21 HL084341
6 · The paper itself

Abstract

backgroundSeveral clinical trials have shown the efficacy of continuous infusion beta-lactam (BL) antibiotics in patients with cystic fibrosis (CF); however, little is known about pharmacokinetic changes during the treatment of an acute pulmonary exacerbation (APE). Identifying and understanding these changes may assist in optimizing antibiotic dosing during APE treatment.

methodsThis study was a retrospective cohort study of 162 adult patients with CF admitted to the University of Utah Hospital between January 1, 2008, and May 15, 2014, for treatment of an APE with both a continuous infusion BL and IV tobramycin. We extracted the administered doses of continuous infusion BLs and tobramycin along with serum drug concentrations and calculated medication clearance rates. The primary outcome was change in clearance rates of continuous infusion BLs between day 2 and day 7 of APE treatment.

resultsThe BL clearance rate increased 20.7% (95% CI, 11.42 to 32.49; P < .001), whereas the tobramycin clearance rate decreased 6.3% (95% CI, -12.29 to -4.45; P < .001). The mean percent predicted FEV

conclusionsClinicians should monitor BL levels along with aminoglycoside levels and make dose adjustments to maximize the chance of optimal antibiotic treatment. Continuous infusion BL and tobramycin clearance can change dramatically during the treatment of an APE, which may necessitate significant changes in dosing to achieve optimal antibiotic levels. Clearance rates of these antibiotics may change in opposite directions, requiring specific monitoring of each medication.

Indexed as

beta-LactamsCystic FibrosisTobramycinAdultAnti-Bacterial AgentsDisease ProgressionDose-Response Relationship, DrugDrug MonitoringFemaleHumansInfusions, IntravenousMaleMetabolic Clearance RateRetrospective StudiesSymptom Flare UpAnti-Bacterial Agentsbeta-LactamsTobramycinantibiotic therapycystic fibrosispharmacokinetics

Identifiers

PMID29908155
PMCPMC6689083
OpenAlexW2808541378

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.