Pharmacokinetics of Continuous Infusion Beta-Lactams in the Treatment of Acute Pulmonary Exacerbations in Adult Cystic Fibrosis Patients (original) (raw)

Several clinical trials have demonstrated the efficacy of continuous infusion (CI) beta-lactam (BL) antibiotics in cystic fibrosis (CF) patients; however, little is known regarding pharmacokinetic changes during treatment of an acute pulmonary exacerbation (APE). Identifying and understanding these changes may assist in optimizing antibiotic dosing during APE treatment. This study is a retrospective cohort study of 162 adult CF patients admitted to the University of Utah Hospital between January 1, 2008 and May 15, 2014 for treatment of an APE with both a CI BL and intravenous tobramycin. We extracted the administered doses of CI BL and tobramycin along with serum drug concentrations and calculated medication clearance rates. The primary outcome was change in clearance rates of CI BL between day 2 and day 7 of APE treatment. BL clearance rate increased 20.7% (95% CI, 11.42 - 32.49; p<0.001), whereas tobramycin clearance rate decreased 6.3% (95% CI, -12.29 - -4.45; p<0.001). Th...