Linked Life Data

20625153

Source:http://linkedlifedata.com/resource/pubmed/id/20625153

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
10
pubmed:dateCreated
2010-9-20
pubmed:abstractText
High-dose cefepime therapy is recommended for febrile neutropenia. Safety issues have been raised in a recent meta-analysis reporting an increased risk of mortality during cefepime therapy. Cefepime-related neurological toxicity has been associated with overdosing due to severe renal dysfunction. This study aimed to investigate the association between cefepime plasma concentrations and neurological toxicity in febrile neutropenic patients. Cefepime trough concentrations (by high-performance liquid chromatography) were retrospectively analyzed for 30 adult febrile neutropenic patients receiving the recommended high-dose regimen (6 g/day for a glomerular filtration rate [GFR] of >50 ml/min). The dose adjustment to renal function was evaluated by the ratio of the cefepime daily dose per 100 ml/min of glomerular filtration. The association between cefepime plasma concentrations and neurological toxicity was assessed on the basis of consistent neurological symptoms and/or signs (by NCI criteria). The median cefepime concentration was 8.7 mg/liter (range, 2.1 to 38 mg/liter) at a median of 4 days (range, 2 to 15 days) after the start of therapy. Neurological toxicity (altered mental status, hallucinations, or myoclonia) was attributed to cefepime in 6/30 (20%) patients (median GFR, 45 ml/min; range, 41 to 65 ml/min) receiving a median dose of 13.2 g/day per 100 ml/min GFR (range, 9.2 to 14.3 g/day per 100 ml/min GFR). Cefepime discontinuation resulted in complete neurological recovery for five patients and improvement for one patient. A multivariate logistic regression model confirmed high cefepime concentrations as an independent predictor of neurological toxicity, with a 50% probability threshold at ?22 mg/liter (P = 0.05). High cefepime plasma concentrations are associated with neurological toxicity in febrile neutropenic patients with mild renal dysfunction. Careful adherence to normalized dosing per 100 ml/min GFR is crucial. Monitoring of plasma concentrations may contribute to preventing neurological toxicity of high-dose therapy for this life-threatening condition.
pubmed:commentsCorrections
http://linkedlifedata.com/resource/pubmed/commentcorrection/20625153-10508045, http://linkedlifedata.com/resource/pubmed/commentcorrection/20625153-11191931, http://linkedlifedata.com/resource/pubmed/commentcorrection/20625153-11498064, http://linkedlifedata.com/resource/pubmed/commentcorrection/20625153-11730416, http://linkedlifedata.com/resource/pubmed/commentcorrection/20625153-11850858, http://linkedlifedata.com/resource/pubmed/commentcorrection/20625153-11907668, http://linkedlifedata.com/resource/pubmed/commentcorrection/20625153-12384385, http://linkedlifedata.com/resource/pubmed/commentcorrection/20625153-12627936, http://linkedlifedata.com/resource/pubmed/commentcorrection/20625153-12760858, http://linkedlifedata.com/resource/pubmed/commentcorrection/20625153-12871648, http://linkedlifedata.com/resource/pubmed/commentcorrection/20625153-12887262, http://linkedlifedata.com/resource/pubmed/commentcorrection/20625153-14982986, http://linkedlifedata.com/resource/pubmed/commentcorrection/20625153-16048982, http://linkedlifedata.com/resource/pubmed/commentcorrection/20625153-16176116, http://linkedlifedata.com/resource/pubmed/commentcorrection/20625153-1622165, http://linkedlifedata.com/resource/pubmed/commentcorrection/20625153-16863493, http://linkedlifedata.com/resource/pubmed/commentcorrection/20625153-18175786, http://linkedlifedata.com/resource/pubmed/commentcorrection/20625153-18651542, http://linkedlifedata.com/resource/pubmed/commentcorrection/20625153-2401125, http://linkedlifedata.com/resource/pubmed/commentcorrection/20625153-8678100
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Oct
pubmed:issn
1098-6596
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
54
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
4360-7
pubmed:dateRevised
2011-7-27
pubmed:meshHeading
pubmed:year
2010
pubmed:articleTitle
High cefepime plasma concentrations and neurological toxicity in febrile neutropenic patients with mild impairment of renal function.
pubmed:affiliation
Infectious Diseases Service, Department of Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Rue du Bugnon 46, CH-1011 Lausanne, Switzerland.
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't