The Use of Doripenem in Pediatric Cystic Fibrosis Patients in Case of Meropenem Shortages

Zobell, Jeffery T.; Kemper, A.; Young, David C.

doi:10.1002/ppul.22798

Cited by 7 publications

(3 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…doripenem replaced meropenem in the therapy of pediatric patients with cystic fibrosis [12]. This strategy cannot be 100% applied to neonatal care, since possible alternatives may not have been studied in neonates.…”

Section: Discussionmentioning

confidence: 99%

Prescription Drug Shortages: Impact on Neonatal Intensive Care

et al. 2018

View full text Add to dashboard Cite

Background: Prescription drug shortages have increased significantly during the past two decades and also impact drugs used in critical care and pediatrics. Objectives: To analyze drug shortages affecting medications used in neonatal intensive care units (NICUs). Methods: Drug shortage data for the top 100 NICU drugs were retrieved from the University of Utah Drug Information Service from 2001 to 2016. Data were analyzed focusing on drug class, formulation, reason for shortage, and shortage duration. Results: Seventy-four of the top 100 NICU drugs were impacted by 227 shortages (10.3% of total shortages). Twenty-eight (12.3%) shortages were unresolved as of December 2016. Resolved shortages had a median duration of 8.8 months (interquartile range 3.6–21.3), and generic drugs were involved in 175 (87.9%). An alternative agent was available for 171 (85.8%) drugs but 120 (70.2%) of alternatives were also affected by shortages. Parenteral drugs were involved in 172 (86.4%) shortages, with longer durations than nonparenteral drugs (9.9 vs. 6.4 months, p = 0.022). The most common shortage reason was manufacturing problems (32.2%). Conclusions: Drug shortages affected many agents used in NICUs, which can have quality and safety implications for patient care, especially in extremely low birth weight infants. Neonatologists must be aware of current shortages and implement mitigation strategies to optimize patient care.

show abstract

Section: Discussionmentioning

confidence: 99%

Prescription Drug Shortages: Impact on Neonatal Intensive Care

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Intermittent extended infusion of doripenem was successfully used in a patient with history of methicillin-sensitive S. aureus, S. maltophilia, Pseudomonas stutzeri , and B. cenocepacia infections and showing meropenem shortage ( Zobell et al, 2014 ). The report demonstrated that it is possible to administer doripenem also in children and that its intermittent extended infusion is effective to improve pulmonary function.…”

Section: New Therapies and Approaches To Overcome B Cenocementioning

confidence: 99%

Burkholderia cenocepacia Infections in Cystic Fibrosis Patients: Drug Resistance and Therapeutic Approaches

et al. 2017

View full text Add to dashboard Cite

Burkholderia cenocepacia is an opportunistic pathogen particularly dangerous for cystic fibrosis (CF) patients. It can cause a severe decline in CF lung function possibly developing into a life-threatening systemic infection known as cepacia syndrome. Antibiotic resistance and presence of numerous virulence determinants in the genome make B. cenocepacia extremely difficult to treat. Better understanding of its resistance profiles and mechanisms is crucial to improve management of these infections. Here, we present the clinical distribution of B. cenocepacia described in the last 6 years and methods for identification and classification of epidemic strains. We also detail new antibiotics, clinical trials, and alternative approaches reported in the literature in the last 5 years to tackle B. cenocepacia resistance issue. All together these findings point out the urgent need of new and alternative therapies to improve CF patients’ life expectancy.

show abstract

“…Patients received between 75 and 90 mg/kg/day of the drug in 3 divided doses utilizing an infusion of 1 hour. Possible adverse reactions to the drug were mild in nature and did not require discontinuation [Zobell et al 2014].…”

Section: Characteristic Resultsmentioning

confidence: 99%

Safety of high-dose doripenem in adult patients with cystic fibrosis

Strawbridge

Nailor

2016

Therapeutic Advances in Drug Safety

View full text Add to dashboard Cite

Background: High doses of β-lactam antibiotics have been advocated for acute pulmonary exacerbations caused by Pseudomonas aeruginosa in patients with cystic fibrosis (CF) secondary to high minimum inhibitory concentrations (MIC) of the infecting organisms. Some β-lactam antibiotics have increased elimination in CF patients. This case series examines the safety of high-dose doripenem (HDD), 2 g intravenously every 8 hours, which is 4 times the labeled dose, in CF patients. Methods: This was a retrospective, single site, chart review of all CF patients given HDD during a 3-year period. Adverse events were prospectively defined using labeled definitions within the package insert and the medical literature. A standard case report form was used to collect demographic details, antibiotic lengths of therapy and adverse events. Results: A total of 17 patients (9 males), with a median age of 24 years, contributed 43 unique visits and 382 HDD exposure days. Mean duration of inpatient doripenem use was 8.9 days. Concurrent antibiotics were common, with a median number of additional antibiotics per admission of three. The median number of adverse effects documented was two. The most common adverse event was anemia, which was identified in 41 of 43 visits, but was present on admission in 31 instances. One patient developed leukopenia for 1 day, but returned to normal without dose adjustment. There were three instances of Clostridium difficile infection. One patient was documented to have an allergic reaction that led to discontinuation, but was ultimately rechallenged without adverse effect. Other common adverse events were gastrointestinal in origin. No other possible adverse effects led to discontinuation of the drug. Conclusions: In adult patients with CF, HDD in combination with other antibiotics did not lead to adverse effects necessitating discontinuation. HDD should be considered in this selected patient population, particularly when high MIC organisms are identified.

show abstract

The Use of Doripenem in Pediatric Cystic Fibrosis Patients in Case of Meropenem Shortages

Cited by 7 publications

References 15 publications

Prescription Drug Shortages: Impact on Neonatal Intensive Care

Prescription Drug Shortages: Impact on Neonatal Intensive Care

Burkholderia cenocepacia Infections in Cystic Fibrosis Patients: Drug Resistance and Therapeutic Approaches

Safety of high-dose doripenem in adult patients with cystic fibrosis

Contact Info

Product

Resources

About