Determination of ampicillin plasma concentrations in single-dose administration for cardiac surgery prophylaxis

Kubíčková, Vendula; Šantavý, Petr; Urbánek, Karel

doi:10.36290/far.2022.001

Cited by 3 publications

(1 citation statement)

References 5 publications

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“…The bioanalytical assay was performed in accordance with the European Medicine Agency guidelines and has been previously described in more detail [ 18 , 19 , 20 ].…”

Section: Methodsmentioning

confidence: 99%

Population Pharmacokinetics of Prophylactic Cefazolin in Cardiac Surgery with Standard and Minimally Invasive Extracorporeal Circulation

et al. 2022

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The objectives of this study were to develop a population pharmacokinetic model of prophylactically administered cefazolin in patients undergoing cardiac surgery with and without the use of the cardiopulmonary bypass of both existing types—standard (ECC) and minimallyu invasive extracorporeal circulation (MiECC)—and to propose cefazoline dosing optimization based on this model. A total of 65 adult patients undergoing cardiac surgery were recruited to this clinical trial. A prophylactic cefazolin dose of 2 g was intravenously administered before surgery. Blood samples were collected using a rich sampling design and cefazolin serum concentrations were measured using the HPLC/UV method. The pharmacokinetic population model was calculated using a nonlinear mixed-effects modeling approach, and the Monte Carlo simulation was used to evaluate the PK/PD target attainment. The population cefazolin central volume of distribution (Vd) of 4.91 L increased by 0.51 L with each 1 m2 of BSA, peripheral Vd of 22.07 L was reduced by 0.77 L or 0.79 L when using ECC or MiECC support, respectively, while clearance started at 0.045 L/h and increased by 0.49 L/h with each 1 mL/min/1.73 m2 of eGFR. ECC/MiECC was shown to be covariate of cefazolin Vd, but without relevance to clinical practice, while eGFR was most influential for the PK/PD target attainment. The standard dose of 2 g was sufficient for PK/PD target attainment throughout surgery in patients with normal renal status or with renal impairment. In patients with augmented renal clearance, an additive cefazolin dose should be administered 215, 245, 288 and 318 min after the first dose at MIC of 4, 3, 2 and 1.5 mg/L, respectively.

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“…The bioanalytical assay was performed in accordance with the European Medicine Agency guidelines and has been previously described in more detail [ 18 , 19 , 20 ].…”

Section: Methodsmentioning

confidence: 99%

Population Pharmacokinetics of Prophylactic Cefazolin in Cardiac Surgery with Standard and Minimally Invasive Extracorporeal Circulation

et al. 2022

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Population pharmacokinetic model-based dosing proposal for ampicillin prophylaxis in cardiac surgery patients with cardiopulmonary bypass

Urbánek

Šantavý

Zuščich

et al. 2023

Journal of Chemotherapy

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Population pharmacokinetics of three alternative prophylactic antibiotics during cardiac surgery with extracorporeal circulation

Šantavý¹,

Kubíčková²,

Šíma³

et al. 2023

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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The aim of this pharmacokinetic study was to describe and quantify population pharmacokinetics of three antibiotics, cefazolin, ampicillin, and ciprofloxacin, used as antibacterial prophylaxis during cardiovascular surgery with the use of extracorporeal circulation (ECC). Methods. Adult patients undergoing cardiac surgery with ECC were enrolled to this prospective, pharmacokinetic study. An intravenous bolus of 2 g of ampicillin, 2 g of cefazolin or 400 mg of ciprofloxacin was administered 60-30 min before surgery. Blood samples were collected at 15, 30, 45, 60, 120 and 180 min after the administration and at the end of the surgery. Plasma concentrations of the antibiotics were measured using HPLC methods. Serum concentrationtime profiles were analyzed using nonlinear mixed-effects modeling approach. Results. A total of 54 patients were enrolled into the study, 20 with ampicillin, 25 cefazolin and 9 ciprofloxacin. For all antibiotics, population pharmacokinetic models have been successfully developed. Conclusion.We identified estimated glomerular filtration rate (eGFR) as the main factor determining the achievement of the pharmacokinetic/pharmacodynamic (PK/PD) target in ampicillin or cefazolin and body weight in ciprofloxacin prophylaxis during cardiac surgery with ECC support.

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Determination of ampicillin plasma concentrations in single-dose administration for cardiac surgery prophylaxis

Cited by 3 publications

References 5 publications

Population Pharmacokinetics of Prophylactic Cefazolin in Cardiac Surgery with Standard and Minimally Invasive Extracorporeal Circulation

Population Pharmacokinetics of Prophylactic Cefazolin in Cardiac Surgery with Standard and Minimally Invasive Extracorporeal Circulation

Population pharmacokinetic model-based dosing proposal for ampicillin prophylaxis in cardiac surgery patients with cardiopulmonary bypass

Population pharmacokinetics of three alternative prophylactic antibiotics during cardiac surgery with extracorporeal circulation

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