PMID- 35453208
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230308
IS  - 2079-6382 (Print)
IS  - 2079-6382 (Electronic)
IS  - 2079-6382 (Linking)
VI  - 11
IP  - 4
DP  - 2022 Mar 28
TI  - Pharmacokinetic/Pharmacodynamic Analysis and Dose Optimization of Cefmetazole and 
      Flomoxef against Extended-Spectrum beta-Lactamase-Producing Enterobacterales in 
      Patients with Invasive Urinary Tract Infection Considering Renal Function.
LID - 10.3390/antibiotics11040456 [doi]
LID - 456
AB  - The optimal regimens of cefmetazole and flomoxef for the treatment of urinary 
      tract infections caused by extended-spectrum beta-lactamase (ESBL)-producing 
      Enterobacterales are not well defined. Our study found that the 
      pharmacokinetic/pharmacodynamic targets for cefmetazole and flomoxef were 70% T > 
      MIC, which is suggestive of bactericidal activity. A Monte Carlo simulation (MCS) 
      was performed using the published data to calculate a new probability of target 
      attainment (PTA >/= 90%) for each renal function. The MCS was performed with 1000 
      replicates, and clinical breakpoints were calculated to attain PTA >/= 90% for 
      creatinine clearance (CCR) of 10, 30, 50, and 70 mL/min. The 90% >/= PTA (70% T > 
      MIC) of cefmetazole and flomoxef in patients who received a standard regimen (0.5 
      or 1 g, 1 h injection) for each renal function was calculated. Our results 
      suggest that in patients with CCR of less than 30, 31-59, and more than 60 
      mL/min, the optimal dosage of cefmetazole would be 1 g q12 h, 1 g q8 h, and 1 g 
      q6 h, respectively. Furthermore, in patients with CCR of less than 10, 10-50, and 
      more than 50 mL/min, the optimal dosage of flomoxef would be 1 g q24 h, 1 g q8 h 
      or 12 h, and 1 g q6 h, respectively.
FAU - Hamada, Yukihiro
AU  - Hamada Y
AUID- ORCID: 0000-0002-5659-6507
AD  - Department of Pharmacy, Tokyo Women's Medical University Hospital, Tokyo 
      162-8666, Japan.
FAU - Kasai, Hidefumi
AU  - Kasai H
AUID- ORCID: 0000-0001-5231-8027
AD  - School of Medicine, Keio University, Tokyo 160-8582, Japan.
FAU - Suzuki-Ito, Moeko
AU  - Suzuki-Ito M
AD  - Department of Pharmacy, Tokyo Women's Medical University Hospital, Tokyo 
      162-8666, Japan.
FAU - Matsumura, Yasufumi
AU  - Matsumura Y
AUID- ORCID: 0000-0001-8595-8944
AD  - Department of Clinical Laboratory Medicine, Kyoto University Graduate School of 
      Medicine, Kyoto 606-8507, Japan.
FAU - Doi, Yohei
AU  - Doi Y
AD  - Center for Innovative Antimicrobial Therapy, Division of Infectious Diseases, 
      University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA.
AD  - Department of Microbiology and Infectious Diseases, Fujita Health University 
      School of Medicine, Aichi 470-1192, Japan.
FAU - Hayakawa, Kayoko
AU  - Hayakawa K
AD  - Disease Control and Prevention Center, National Center for Global Health and 
      Medicine, Tokyo 162-8655, Japan.
LA  - eng
GR  - 19A1022/Ministry of Health Labour and Welfare/
PT  - Journal Article
DEP - 20220328
PL  - Switzerland
TA  - Antibiotics (Basel)
JT  - Antibiotics (Basel, Switzerland)
JID - 101637404
PMC - PMC9027114
OTO - NOTNLM
OT  - Monte Carlo simulations
OT  - antimicrobial stewardship
OT  - cefmetazole
OT  - flomoxef
OT  - pharmacokinetics/pharmacodynamics
COIS- Y.D. has consulted for Gilead, Shionogi, Pfizer, Janssen, and bioMerieux; has 
      received speaking fees from AstraZeneca and FujiFilm; and has received research 
      funding from MSD, Astellas, Shionogi, Pfizer, Janssen, and Kanto Chemical. The 
      other authors have no conflict of interest to declare.
EDAT- 2022/04/24 06:00
MHDA- 2022/04/24 06:01
PMCR- 2022/03/28
CRDT- 2022/04/23 01:00
PHST- 2022/02/22 00:00 [received]
PHST- 2022/03/24 00:00 [revised]
PHST- 2022/03/25 00:00 [accepted]
PHST- 2022/04/23 01:00 [entrez]
PHST- 2022/04/24 06:00 [pubmed]
PHST- 2022/04/24 06:01 [medline]
PHST- 2022/03/28 00:00 [pmc-release]
AID - antibiotics11040456 [pii]
AID - antibiotics-11-00456 [pii]
AID - 10.3390/antibiotics11040456 [doi]
PST - epublish
SO  - Antibiotics (Basel). 2022 Mar 28;11(4):456. doi: 10.3390/antibiotics11040456.