Impact of Obesity on Ceftriaxone Efficacy
Background: Ceftriaxone has standard, set dosing regimens that may not achieve adequate serum concentrations in obese patients compared to non-obese patients. The purpose of this study was to evaluate the effect of obesity on ceftriaxone efficacy when used as definitive monotherapy to treat infections. Methods: This retrospective cohort included adult inpatients treated with ceftriaxone monotherapy for ≥72 h between July 01, 2015-July 31, 2017. Patients were excluded if their infection lacked source control within 72 h or if they had polymicrobial infections requiring more than one antibiotic for definitive therapy. The primary outcome was the rate of clinical failure between obese versus non-obese patients, defined as a composite of (1) change in definitive therapy > 72 h due to clinical worsening; (2) residual leukocytosis (white blood cell count (WBC) > 10 × 109/L) > 72 h after treatment initiation; (3) presence of a fever (single temperature > 100.9 °F) > 72 h after treatment initiation; or (4) readmission within 30 days due to re-infection with the same organism. Results: A total of 101 patients were included in the study: 39 obese and 62 non-obese. The most common indications for ceftriaxone were urinary tract (52.5%), respiratory tract (24.8%), and bloodstream (24.8%) infections. The most commonly isolated organisms were Escherichia coli (48.5%) and Klebsiella species (15.8%). Most patients received 1g every 24 h. Clinical failure was observed in 61.5% of obese patients versus 40.3% of non-obese patients (p = 0.038). Conclusion: Obese patients treated with ceftriaxone were more likely to experience clinical failure when compared to non-obese patients. Further analyses are warranted to determine if weight-based dosing is required in obese patients treated with ceftriaxone.
Medienart: |
E-Artikel |
---|
Erscheinungsjahr: |
2020 |
---|---|
Erschienen: |
2020 |
Enthalten in: |
Zur Gesamtaufnahme - volume:8 |
---|---|
Enthalten in: |
Diseases (Basel, Switzerland) - 8(2020), 3 vom: 09. Juli |
Sprache: |
Englisch |
---|
Beteiligte Personen: |
Barber, Katie E [VerfasserIn] |
---|
Links: |
---|
Themen: |
Ceftriaxone |
---|
Anmerkungen: |
Date Revised 28.10.2020 published: Electronic Citation Status PubMed-not-MEDLINE |
---|
doi: |
10.3390/diseases8030027 |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
NLM312367511 |
---|
LEADER | 01000naa a22002652 4500 | ||
---|---|---|---|
001 | NLM312367511 | ||
003 | DE-627 | ||
005 | 20231225144251.0 | ||
007 | cr uuu---uuuuu | ||
008 | 231225s2020 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.3390/diseases8030027 |2 doi | |
028 | 5 | 2 | |a pubmed24n1041.xml |
035 | |a (DE-627)NLM312367511 | ||
035 | |a (NLM)32660113 | ||
035 | |a (PII)E27 | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
100 | 1 | |a Barber, Katie E |e verfasserin |4 aut | |
245 | 1 | 0 | |a Impact of Obesity on Ceftriaxone Efficacy |
264 | 1 | |c 2020 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a ƒaComputermedien |b c |2 rdamedia | ||
338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
500 | |a Date Revised 28.10.2020 | ||
500 | |a published: Electronic | ||
500 | |a Citation Status PubMed-not-MEDLINE | ||
520 | |a Background: Ceftriaxone has standard, set dosing regimens that may not achieve adequate serum concentrations in obese patients compared to non-obese patients. The purpose of this study was to evaluate the effect of obesity on ceftriaxone efficacy when used as definitive monotherapy to treat infections. Methods: This retrospective cohort included adult inpatients treated with ceftriaxone monotherapy for ≥72 h between July 01, 2015-July 31, 2017. Patients were excluded if their infection lacked source control within 72 h or if they had polymicrobial infections requiring more than one antibiotic for definitive therapy. The primary outcome was the rate of clinical failure between obese versus non-obese patients, defined as a composite of (1) change in definitive therapy > 72 h due to clinical worsening; (2) residual leukocytosis (white blood cell count (WBC) > 10 × 109/L) > 72 h after treatment initiation; (3) presence of a fever (single temperature > 100.9 °F) > 72 h after treatment initiation; or (4) readmission within 30 days due to re-infection with the same organism. Results: A total of 101 patients were included in the study: 39 obese and 62 non-obese. The most common indications for ceftriaxone were urinary tract (52.5%), respiratory tract (24.8%), and bloodstream (24.8%) infections. The most commonly isolated organisms were Escherichia coli (48.5%) and Klebsiella species (15.8%). Most patients received 1g every 24 h. Clinical failure was observed in 61.5% of obese patients versus 40.3% of non-obese patients (p = 0.038). Conclusion: Obese patients treated with ceftriaxone were more likely to experience clinical failure when compared to non-obese patients. Further analyses are warranted to determine if weight-based dosing is required in obese patients treated with ceftriaxone | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a Gram-negative infections | |
650 | 4 | |a ceftriaxone | |
650 | 4 | |a clinical failure | |
650 | 4 | |a obesity | |
700 | 1 | |a Loper, J Taylor |e verfasserin |4 aut | |
700 | 1 | |a Morrison, Austin R |e verfasserin |4 aut | |
700 | 1 | |a Stover, Kayla R |e verfasserin |4 aut | |
700 | 1 | |a Wagner, Jamie L |e verfasserin |4 aut | |
773 | 0 | 8 | |i Enthalten in |t Diseases (Basel, Switzerland) |d 2013 |g 8(2020), 3 vom: 09. Juli |w (DE-627)NLM242728715 |x 2079-9721 |7 nnns |
773 | 1 | 8 | |g volume:8 |g year:2020 |g number:3 |g day:09 |g month:07 |
856 | 4 | 0 | |u http://dx.doi.org/10.3390/diseases8030027 |3 Volltext |
912 | |a GBV_USEFLAG_A | ||
912 | |a GBV_NLM | ||
951 | |a AR | ||
952 | |d 8 |j 2020 |e 3 |b 09 |c 07 |