Cefepime Pharmacokinetics in Critically Ill Pediatric Patients Receiving Continuous Renal Replacement Therapy

DOI: 10.1128/AAC.02006-18

Article Figures & Data

TABLE 1

Patient demographics

Characteristic	Data by patient
Characteristic	1	2	3	4
Age (yr)	1.1	0.6	0.5	5
Sex	Male	Female	Male	Male
Hospital admission diagnosis	Liver transplant	Liver failure	Hyponatremia	HLH^a
Estimated dry wt (kg)	10	6	5.4	25
Body surface area (m²)	0.45	0.33	0.33	0.94
Baseline SCr (mg/dl)^b	0.14	Unknown^c	0.15	0.3
SCr at CRRT initiation (mg/dl)	0.41	0.53	0.59	3.37
Mean urine output at CRRT initiation (ml/kg/h)^d	1.3	1.6	1.4	0.25
Mean urine output at sampling (ml/kg/h)^e	0.22	0.64	0.07	0
Cefepime dose (mg/kg)^f	48	57	55	64
Dosing interval (h)	8	8	6	12
Infusion time (h)	3	0.5	0.5	0.5
No. of samples collected	3	2	3	3
No. of doses received prior to first sample	18	3	7	2

TABLE 2

CVVHDF parameters

Parameter	Data by patient
Parameter	1	2	3	4
Dialysate (ml/h)	1,500	1,000	550	650
Pre-filter replacement (ml/h)	500	450	500	600
Post-filter replacement (ml/h)	50	50	50	50
Blood flow (ml/min)	90	40	70	100
Blood flow (ml/kg/min)	9	6.7	13	4
Normalized effluent rate (ml/1.73 m²/h)	8,750	8,593	6,089	3,076
Effluent urea/BUN ratio^a	0.75	0.75	0.75	0.77
Delivered CVVHDF clearance (ml/1.73 m²/h)^b	6,563	6,445	4,567	2,369
Circuit age (h)^c	22.6	33.8	15.2	11.2

↵a BUN, blood urea nitrogen.
↵b Delivered CVVHDF clearance = normalized effluent rate × BUN/effluent urea nitrogen ratio.
↵c Measured from circuit change to time of cefepime dose prior to sampling.

TABLE 3

Calculated PK and PD parameters