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Antimicrobial Agents and Chemotherapy, July 1998, p. 1783-1787, Vol. 42, No. 7
Pharmacy Department1
and
Infectious Diseases,2 Metropolitan
Hospital, Grand Rapids, Michigan 49506
Received 3 October 1997/Returned for modification 12 March
1998/Accepted 27 April 1998
Ceftizoxime is a widely used beta-lactam antimicrobial agent, but
pharmacokinetic data for use with clinically ill patients are lacking. We studied the population pharmacokinetics of ceftizoxime in 72 clinically ill patients at a community-based,
university-affiliated hospital. A population pharmacokinetic model for
ceftizoxime was created by using a prospective observational design.
Ceftizoxime was administered by continuous infusion to treat patients
with proven or suspected bacterial infections. While the patients were receiving infusions of ceftizoxime, serum samples were
collected for pharmacokinetic analysis with the nonlinear mixed-effect
modeling program NONMEM. In addition to clearance and volume of
distribution, various comorbidities were examined for their influence
on the kinetics. All 72 subjects completed the study, and 114 serum
samples were collected. Several demographic and comorbidity variables, namely, age, weight, serum creatinine levels, congestive heart failure,
and long-term ventilator dependency, had a significant impact on the
estimate for ceftizoxime clearance. A mixture model, or two populations
for estimation of ceftizoxime clearance, was discovered. One
population presented with an additive clearance component of 1.6 liters
per h. In addition, a maximizer function for serum
creatinine levels was found. In summary, two models for ceftizoxime
clearance, mixture and nonmixture, were found and are presented.
Clearance for ceftizoxime can be estimated with commonly
available clinical information and the models presented. From the
clearance estimates, the dose of ceftizoxime to maintain the desired concentration in serum can be determined. Work is needed to
validate the model for drug clearance and to evaluate its predictive
performance.
0066-4804/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
Population Pharmacokinetics of Ceftizoxime
Administered by Continuous Infusion in Clinically Ill Adult
Patients
*
Corresponding author. Mailing address: Metropolitan
Hospital Pharmacy Department, 1919 Boston, Grand Rapids, MI 49506. Phone: (616) 222-7938. Fax: (616) 247-7478. E-mail:
faccaetal{at}MSN.com.
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