Martínez ZJJ, Pacheco MMM, Rada OI

Language: Spanish
References: 12
Page: 213-224
PDF size: 113.85 Kb.

ABSTRACT

Introduction: the use of drugs out of therapeutic ranges is a hospital problem since the anthropometric parameters of patients, which are determinants in the drug concentrations, are rarely taken into consideration.
Objectives: to implement a mathematical model based on the patient's parameters in order to determine the possible plasma cephalotine concentrations and to compare them with the minimum inhibitory concentrations for isolated microorganisms.
Methods: a group of male patients aged 18 to 50 years under postsurgical prophylactic treatment with cephalotine was selected. Data was collected on cephalotin dosage, weight, size, age and hematocrit. Extracellular, plasma and blood volumes were estimated by the Hedin's informed model. Additionally, the plasma cephalotin concentration was measured by using the model suggested in this study and then compared with the minimum inhibitory concentration for the isolated microorganisms.
Results: twenty four patients aged 32.6 years ± 8, weighing 69 kg ± 7.51, with size of 168.87 cm ± 7.10 were analyzed. Resistance to concentrations equal to or higher than 32 µg/mL was observed in 56.3 % of microorganisms. The most common agent was Escherichia coli in 18 isolated strains. The comparison of the distribution volume and of the plasma cephalotin concentration estimated with the Hedin's informed model and with the model devised in the present paper did not show significant differences according to Student's t test result, with p ‹ 0.05.
Conclusions: the comparison of the theoretical concentrations of cephalotine for inhospital postsurgical prophylactic use estimated by the model yielded that these concentrations did not allow overcoming the minimum inhibitory concentration for the isolated microorganisms.

REFERENCES

1. Calvo MV, García MJ, Martínez J, Fernández MM. Farmacocinética clínica. En: Bonal J, Domínguez-Gil A, Gamundi MC, Nopal V. Valverde E (editores). Farmacia hospitalaria. Madrid: Sociedad Española de Farmacia Hospitalaria; 2002.

2. Alviz A, Caraballo R, Martínez J. Guías de manejo Formulario Farmacoterapéutico del adulto de la E.S.E Hospital Universitario del Caribe. Cartagena: Editorial Mila; 2010.

3. Sweetman Sean C. Martindale, The Complete Drug Reference. 36a ed. London: Pharmaceutical Press; 2009.

4. Scott Obach R, Lombardo F, Waters Nigel J. Trend Analysis of a Database of Intravenous Pharmacokinetic Parameters in Humans for 670 Drug Compounds. Drug Metabolism Disposition. 2008;36(7):1385-405.

5. Ohnishi Ayaco, Yano Yoshitaka, Ishibashi Toru, Katsube Takayuki, Oguma Takayoshi. Evaluation of Bayesian predictability of Vancomicyn concentration using population pharmacokinetic parameters in pediatric patients. Drug Metab Pharmacokinet. 2005;20(6):415-22.

6. Waters Nigel J, Lombardo F. Use of the Øie-Tozer Model in Understanding Mechanisms and Determinants of Drug Distribution. Drug Metabolism Disposition. 2010;38(7):1159-65.

7. Hedin A, Hahn RG. Volume expansion and plasma protein clearance during intravenous infusion of 5 % albumin and autologous plasma. Clin Sci. 2005;108:217-24.

8. LeFever KJ. Paulanka BJ, Polek C. Handbook of fluid, electrolyte and acid-base imbalances. 3th ed. Delmar: United States of America; 2010.

9. Anton Y. Hospital-cquired Infections Due to Gram-Negative Bacteria. N Engl J Med. 2010;362:1804-13.

10. Domínguez Soto O, Hernández Foronda JC, Piedrahíta Palacio N, Saldarriaga Mejía N, Vanegas Cardona DM, González Arroyave JC. Características clínico-epidemiológicas de las infecciones por Enterobacter en la Clínica Cardiovascular de Medellín. Agosto de 2004 a agosto de 2006. Medicina UPB. 2008 Jul.-Dic.;27(2):101-11.

11. Rodríguez Quebrado MG, Barrios Casarrubias A, Ramírez Franco A. Frecuencia de infecciones nosocomiales y la resistencia de las bacterias de heridas quirúrgicas de dos hospitales de salud de Chilpancingo Guerrero. Bioquimia. 2007 Mar.;32(Supl A):123.

12. Guevara Rodríguez M, Romero Zúñiga JJ. Factores asociados a la infección hospitalaria de la herida operatoria en pacientes de cirugía limpia electiva en el Hospital "Dr. Rafael Ángel Calderón Guardia" de Costa Rica. Acta Méd Costarricense. 2010 Jul.-Setp.;52(3):159-66.