Evidence map›Paper›PMID 37466170›Full record

ArticleThe Journal of antimicrobial chemotherapy2023

Cefepime pharmacokinetics in critically ill children and young adults undergoing continuous kidney replacement therapy.

Kathryn Pavia, H Rhodes Hambrick, Kelli Paice, Peter Tang, Nieko Punt, Jennifer Kaplan, Stuart L Goldstein, Alexander A Vinks, Tomoyuki Mizuno, Sonya Tang Girdwood

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of antimicrobial chemotherapy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.5field-weighted citation impact, top 19% 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

5 citing papers in PubMed, 6 citations in OpenAlex.

  1. Trial
  2. Review
  3. Review
  4. Review
  5. 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

10 authors at 2 institutions in 2 countries.

Kathryn PaviaDivision of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
H Rhodes HambrickDivision of Clinical Pharmacology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Kelli PaiceDivision of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Peter TangDivision of Pathology and Laboratory Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Nieko PuntUniversity Medical Center Groningen, Department of Clinical Pharmacy and Pharmacology, University of Groningen, Groningen, The Netherlands.
Jennifer KaplanDivision of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Stuart L GoldsteinDivision of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Alexander A VinksDivision of Clinical Pharmacology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Tomoyuki MizunoDivision of Clinical Pharmacology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Sonya Tang GirdwoodDivision of Clinical Pharmacology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.ORCID 0000-0001-7737-8499
Cincinnati Children's Hospital Medical Center · USUniversity Medical Center Groningen · NL

Funding

T32 Cincinnati Pediatric Clinical Pharmacology Training ProgramT32HD069054 · NICHD · CINCINNATI CHILDRENS HOSP MED CTR · PI TRACY A GLAUSER, Sonya C Tang Girdwood · 2011 to 2026
$3.0M
RESEARCH TRAINING IN PEDIATRIC NEPHROLOGYT32DK007695 · NIDDK · CINCINNATI CHILDRENS HOSP MED CTR · PI DEVARAJAN, PRASAD · 1992 to 2023
$2.2M
Antibiotic Model-Informed Precision Dosing in Critical IllnessR35GM146701 · NIGMS · CINCINNATI CHILDRENS HOSP MED CTR · PI Sonya C Tang Girdwood · 2022 to 2026
$2.0M
NICHD NIH HHS T32 HD069054NIDDK NIH HHS T32 DK007695NIGMS NIH HHS R35 GM146701NIH HHS
6 · The paper itself

Abstract

objectivesCefepime is an antibiotic commonly used to treat sepsis and is cleared by renal excretion. Cefepime dosing requires adjustment in patients with decreased kidney function and in those receiving continuous kidney replacement therapy (CKRT). We aimed to characterize cefepime PK in a diverse cohort of critically ill paediatric patients on CKRT.

methodsPatients were identified from an ongoing pharmacokinetic/pharmacodynamic (PK/PD) study of beta-lactam antibiotics, and were included if they had received at least two cefepime doses in the ICU and were on CKRT for at least 24 h. PK parameters were estimated using MwPharm++ with Bayesian estimation and a paediatric population PK model. Target attainment was assessed as time of free cefepime concentrations above minimum inhibitory concentration (fT > 1× or 4 × MIC).

resultsSeven patients were included in the study (ages 2 to 20 years). CKRT indications included liver failure (n = 1), renal failure (n = 4) and fluid overload (n = 2). Total effluent flow rates ranged from 1833 to 3115 (mean 2603) mL/1.73 m2/h, while clearance was 2.11-3.70 (mean 3.0) L/h/70 kg. Effluent flows were lower, but clearance and fT > MIC were similar to paediatric data published previously. Using Pseudomonas aeruginosa MIC breakpoints, all patients had 100% of dosing interval above MIC, but only one had 100% of dosing interval above 4× MIC.

conclusionsSince most patients failed to attain stringent targets of 100% fT > 4×  MIC, model-informed precision dosing may benefit such patients.

Indexed as

Continuous Renal Replacement TherapyCritical IllnessAnti-Bacterial AgentsBayes TheoremCefepimeChildHumansMicrobial Sensitivity TestsYoung AdultAnti-Bacterial AgentsCefepime

Identifiers

PMID37466170
PMCPMC10477133
OpenAlexW4384660897

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.