Cefepime neurotoxicity: thresholds and risk factors. A Retrospective Cohort study
| Autor: | Léna Boschung-Pasquier, Philipp Jent, Baharak Babouee Flury, Christoph Hauser, Hansjakob Furrer, Sarah Banholzer, Yok-Ai Que, Andrew Atkinson, Dominique I. Furrer, Manuel Haschke, Leonie Kassandra Kastner, Niccolò Buetti |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
0301 basic medicine Microbiology (medical) medicine.medical_specialty Drug-Related Side Effects and Adverse Reactions Cefepime 030106 microbiology 610 Medicine & health Risk Assessment 03 medical and health sciences 0302 clinical medicine Risk Factors Interquartile range Internal medicine Odds Ratio medicine Humans Trough Concentration Renal Insufficiency 030212 general & internal medicine Retrospective Studies medicine.diagnostic_test business.industry Incidence (epidemiology) Mortality rate Neurotoxicity Retrospective cohort study General Medicine medicine.disease Anti-Bacterial Agents Infectious Diseases Therapeutic drug monitoring Female Drug Monitoring Nervous System Diseases business medicine.drug |
| Zdroj: | Boschung-Pasquier, Léna; Atkinson, Andrew; Kastner, Leonie Kassandra; Banholzer, Sarah; Haschke, Manuel; Buetti, Niccolò; Furrer, Dominique I; Hauser, Christoph; Jent, Philipp; Que, Yok-Ai; Furrer, Hansjakob; Babouee Flury, Baharak (2020). Cefepime neurotoxicity: thresholds and risk factors. A Retrospective Cohort study. Clinical microbiology and infection, 26(3), pp. 333-339. Elsevier 10.1016/j.cmi.2019.06.028 |
| DOI: | 10.1016/j.cmi.2019.06.028 |
| Popis: | OBJECTIVES Toxic serum cefepime trough concentrations are not well defined in the current literature. We aimed to define a more precise plasma trough concentration threshold for this antibiotic's neurological toxicity and to identify patients at risk for developing neurotoxic side effects. METHODS Retrospective study including all patients who underwent cefepime therapeutic drug monitoring (TDM) between 2013 and 2017. Patients with cefepime concentrations other than trough were excluded. The primary outcome was to assess the incidence of neurotoxicity and its relationship with cefepime plasma trough concentrations. Secondary outcomes were the relationship of renal function, cefepime daily dose, age, cerebral and general comorbidities with the occurrence of neurotoxicity. We also compared the mortality rate during hospitalisation in patients with and without neurotoxicity, and the possible impact of neuroprotective co-medications on the outcomes. RESULTS Cefepime concentrations were determined in 584 patients. Among 319 patients with available trough concentrations included, the overall incidence of neurotoxicity was 23.2% (74 of 319 patients). Higher cefepime plasma trough concentrations were significantly associated with risk of (no neurotoxicity 6.3 mg/L [IQR 4.1, 8.6] vs with neurotoxicity 21.6 mg/L [IQR 17.0, 28.6], p |
| Databáze: | OpenAIRE |
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