* Corresponding Author
Perkiraan Kadar Seftazidim dalam Darah pada Pasien Pneumonia dengan Gangguan Fungsi Ginjal
https://doi.org/10.22146/jmpf.37624 Dewi Latifatul Ilma(1*), Djoko Wahyono(2), Ika Puspita Sari(3)
(1) Jurusan Farmasi, Fakultas Ilmu-Ilmu Kesehatan, Universitas Jenderal Soedirman
(2) Faculty of Pharmacy, Gadjah Mada University, Yogyakarta
(3) Faculty of Pharmacy, Gadjah Mada University, Yogyakarta
(*) Corresponding Author
Abstract
Pneumonia is one of the major causes of mortality due to infection in hospitalized patients. It was frequently found in patients with renal failure. Clinical outcomes of infected patients with renal failure are worse compared to patients without renal failure. The presence of renal impairment affects the pharmacokinetics of the drug. Ceftazidime is one of the most commonly used antibiotics in patients with pneumonia. Approximately, 80-90% of ceftazidime’s total drug fraction is eliminated by kidneys so that the presence of kidney disorders will affect the concentration of ceftazidime in the blood. This study aimed to determine the estimated concentration of ceftazidime in the blood and clinical outcome of pneumonia patients with renal impairment. This study was a retrospective study with descriptive observational design. Data were obtained from patient’s medical record in a hospital in Yogyakarta between January 2013-June 2017 which fulfilled the inclusion criteria, i.e., ≥18 years old patients with complete medical record data, treated in internal medicine ward with diagnosis of pneumonia (HAP/HCAP) who had chronic renal failure, and received ceftazidime for minimum 72 hours or 3 days. The number of research samples were 40 patients. This study showed that 31 patients (77.5%) had achieved estimated ceftazidime concentration in the blood above the minimum inhibitory concentration of 8 μg/ mL. After ceftazidime therapy, 19 patients (47.5%) had improved clinical outcome and 21 patients (52.5%) had not improved clinical outcome.
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1. Montravers P, Harpan A, Guivarch E. Current and Future Considerations for the Treatment of Hospital-Acquired Pneumonia. Adv Ther. 2016;33(2):151-166.
2. Azmi S, Mohamed S, Maimaiti N, et al. International Journal of Infectious Diseases Assessing the burden of pneumonia using administrative data from Malaysia , Indonesia , and the Philippines. Int J Infect Dis. 2016;49:87-93.
3. Wang HE, Gamboa C, Warnock DG, Muntner P. Chronic Kidney Disease and Risk of Death from Infection. Am J Nephrol. 2011;34(4):330-336.
4. Su G, Xu H, Marrone G, Lindholm B, Wen Z, Liu X. Chronic kidney disease is associated with poorer in-hospital outcomes in patients hospitalized with infections : Electronic record analysis from China. Sci Rep. 2017;7(1):1-10.
5. Shargel, L. dan Yu AB. Shargel & Yu’s Apllied Biopharmaceutics and Pharmacokinetics. 7th Ed. New York: Mc Graw Hill Education; 2016.
6. ATS. Guidelines for the Management of Adults with Hospital-acquired, Ventilator-associated, and Healthcare-associated Pneumonia. Am J Respir Crit Care Med. 2005;171(4):388-416.
7. Grayson M., Mc Carthy J., Mills J, Mouton J., Norby S. Kucers’ The Use of Antibiotics: A Clinical Review of Antibacterial, Antifungal, Antiparasit, and Antiviral Drugs. Vol 1. Sixth. Boca Raton: CRC Press; 2010.
8. Kalil AC, Metersky ML, Klompas M, et al. Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia : 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society. 2016:1-51.
9. APhA. Drug Information Handbook: A Comprehensive Resources for All Clinicians and Healtchare Professionals. 26th ed. Lexi-Comp Inc; 2017.
10. Kumar A, Khrime D, Bansal N, Pandey AN, Varma A. Evaluation of Antibiotic Dose Adjustment in Patients with Renal Insufficiency in a Tertiary Care Center. Int J Contemp Med Res. 2016;550(5):1383-1385.
11. Izumukawa K, Hashiguchi K, Sawai T, et al. Study on the blood concentration and clinical efficacy of ceftazidim, a cephem antibiotic at a dose of one gram q.i.d for adult hospital-acquired pneumonia patients. Jpn J Antibiot. 2009;62(1):9-16.
12. Beckett CL, Harbarth S, Huttner B. Special considerations of antibiotic prescription in the geriatric population. Clin Microbiol Infect. 2015;21(1):3-9.
13. Weiskopf D, Weinberger B, Grubeck-loebenstein B. The aging of the immune system. Transpl Int. 2009;22(11):1041-1050.
14. Caceres F, Welch VL, Kett DH, et al. Absence of Gender-Based Differences in Outcome of Patients with Hospital-Acquired Pneumonia. J Women’s Heal. 2013;22(12):1069-1075. [MOT4]
15. Seong GM, Kim M, Ph D, et al. Healthcare-Associated Pneumonia among Hospitalized Patients : Is It Different from Community Acquired Pneumonia ? Tuberc Respir Dis (Seoul). 2014;76(2):66-74.
16. Tadros M, Williams V, Coleman BL, et al. Epidemiology and Outcome of Pneumonia Caused by Methicillin-Resistant Staphylococcus aureus ( MRSA ) in Canadian Hospitals. PLoS One. 2013;8(9):4-11.
17. Silveyra P, Fuentes N, Rivera L. Understanding The Intersection of Environmental Pollution, Pneumonia, and Inflammation : Does Gender Play A Role? In: Contemporary Topics of Pneumonia. London: Intech; 2017.
18. Rabello LSCF, Silva JRL, Azevedo LCP, Souza I, Viviane B. Clinical Outcomes and Microbiological Characteristics of Severe Pneumonia in Cancer Patients : A Prospective Cohort Study. PLoS One. 2015;10(3):1-13. [MOT5]
19. Lagacé-wiens P, Walkty A, Karlowsky JA. Ceftazidime – avibactam : an evidence-based review of its pharmacology and potential use in the treatment of Gram-negative bacterial infections. Core Evid. 2014;9:13-25.[MOT6]
20. Seong GM, Kim M, Lee J, et al. Healthcare-Associated Pneumonia among Hospitalized Patients: Is It Different from Community Acquired Pneumonia? Tuberc Respir Dis (Seoul). 2014;76(2):66-74.
21. Hakim L. Farmakokinetika Klinik. Yogyakarta: Bursa Ilmu; 2012.
22. Sharma R, Sapkota S, Khanal D. Correlation of Minimum Inhibitory Concentration of Ciprofloxacin to the Therapeutic Response of Patient With Urinary Tract Infection Caused by Escherichia Coli. IJPSR. 2014;5(3):970-976.
23. Jamal J, Hons B, Hons B, Lipman J, Roberts JA, Hons B. Defining Antibiotic Dosing in Lung Infections. Clin Pul Med. 2013;20(3):121-128.
24. Mayr FB, Yende S, Angus DC. Epidemiology of severe sepsis. Virulence. 2014;5(1):4-11.
25. Sundar KM, Sires M. Sepsis induced immunosuppression : Implications for secondary infections and complications. Indian J Crit Care Med. 2013;17(3):162-169.
26. Hotchkiss RS. Sepsis-induced immunosuppression: from cellular dysfunctions to immunotherapy. Nat Rev Immunol. 2014;13(12):862-874.
27. Blot SI, Pea F, Lipman J. The effect of pathophysiology on pharmacokinetics in the critically ill patient — Concepts appraised by the example of antimicrobial agents. Adv Drug Deliv
Rev. 2014;77:3-11.
28. Verbeeck RK, Musuamba FT. Pharmacokinetics and dosage adjustment in patients with renal dysfunction. Eur J Clin Pharmacol. 2009;65(8):757-773.
29. Loo AS, Neely M, Anderson EJ, Ghossein C, McLaughlin MM, Scheetz MH. Pharmacodynamic Target Attainment for Various Ceftazidime Dosing Schemes in High-Flux Hemodialysis. Antimicrob Agents Chemother. 2013;57(12):5854-5859.
DOI: https://doi.org/10.22146/jmpf.37624
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