ArticleCritical care medicine2025
Cystatin C-Guided Dosing Nomogram Improves Target Attainment for Cefepime in the Critically Ill.
Article in Critical care medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07287332 (BLOOM), which is not on this map. Cited by 2 papers.
What it found
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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.
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.
BLOOM: Pragmatic Feasibility Trial
Who cites it
2 citing papers in PubMed.
- Toward adaptive therapeutic timing: integration of mechanistic pharmacology and artificial intelligence in precision dosing.Frontiers in pharmacology · 2026Review
- Piperacillin/tazobactam clearance predicted by non-creatinine based estimates of GFR in critically ill adults.International journal of antimicrobial agents · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
objectivesEstimated glomerular filtration rate is more accurate with combined creatinine and cystatin C equations (eGFR cr-cys ) than creatinine alone. This study created and evaluated a cefepime dosing nomogram based on eGFR cr-cys for initial dosing in the critically ill.
designPharmacokinetic modeling and simulation study.
settingAcademic medical center. PATIENTS: Critically ill adults treated with cefepime.
interventionsNone. MEASUREMENTS AND MAIN
resultsData from 120 patients with baseline cystatin C and follow-up cefepime levels were used to develop a nomogram based on eGFR cr-cys and weight for initial cefepime dosing. The predicted proportion of patients who achieved a free cefepime concentration above the minimum inhibitory concentration of the organism for 100% of the dosing interval in the first 24 hours (100% ƒT > MIC at 24 hr) was compared between administered doses and those predicted by the nomogram doses. Overall drug exposure was estimated with the free area under the concentration time curve from 0 to 24 hours (ƒAUC 0-24 ) and compared between administered and nomogram doses. Achievement of 100% ƒT > MIC at 24 hours was predicted to be significantly better with the nomogram compared with the administered dose (76% vs. 38%; p < 0.001). The median ƒAUC 0-24 as predicted by the nomogram (666 mg·hr/L) was slightly higher than the actual ƒAUC 0-24 with administered doses (612 mg·hr/L; p = 0.01), but the nomogram led to fewer ƒAUC 0-24 values which were either too high (> 900) or too low (< 300) (7% vs. 20%; p = 0.004).
conclusionsUse of a cystatin C-inclusive dosing nomogram for cefepime could improve target attainment without increasing the risk of potentially toxic levels in the critically ill.
Indexed as
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Registered trials
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.