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首页> 外文期刊>The Pediatric infectious disease journal >Cefoxitin Prophylaxis During Pediatric Cardiac Surgery: Retrospective Exploration of Postoperative Trough Levels
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Cefoxitin Prophylaxis During Pediatric Cardiac Surgery: Retrospective Exploration of Postoperative Trough Levels

机译：小儿心脏手术期间的头孢洛素预防：术后槽水平的回顾性探索

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Background: This study aimed to explore inter-individual variability of cefoxitin trough levels, predictors of serum cefoxitin concentration and the probability of target attainment of drug levels above 4 mg/L after pediatric cardiac surgery. Methods: Retrospective study on children scheduled for elective cardiac surgery and having cefoxitin trough levels available up to 24 hours postsurgery. Results: Overall, 68 children (9 neonates, 34 infants, 15 children below or equal to 10 years old and 10 patients above this age) were included. Of these, 16 surgeries were performed off cardiopulmonary bypass and 52 were performed on cardiopulmonary bypass. The free cefoxitin concentrations showed a median (interquartile range) concentration of 1.7 (0.6-4.2) mg/L. The range of cefoxitin concentrations showed a 150-fold and 340-fold variability at cardiac intensive care unit admission and after 24 hours, respectively. The pharmacodynamics (PD) targets of free cefoxitin at 100% of the dosing interval, considering Eucast breakpoints for Methicillin Sensitive Staphylococcus Aureus (4 mg/L) and E.Coli (8 mg/L), were obtained in 28% and 16% of patients, respectively. Patient weight (odds ratio, 0.7; 95% confidence interval, 0.62-0.92; P = 0.006) and serum creatinine concentrations (odds ratio, 25; 95% confidence interval, 18-36; P = 0.004) showed a significant relationship with the PD targets. Conclusions: Cefoxitin trough concentrations vary significantly in the first 24 hours after pediatric cardiac surgery. Both serum creatinine and body weight showed independent associations with cefoxitin concentration. The PD target was not obtained in the vast majority of the explored population, regardless of the target bacteria.
机译：背景：本研究旨在探讨头孢克碱槽水平的个体间可变异，血清细菌素浓度的预测因子以及小儿心脏手术后4毫克/升药物水平的目标达到的概率。方法：对选修心脏手术的患儿进行回顾性研究，并具有高达24小时的食物蛋白槽水平。结果：总体而言，68名儿童（9名新生儿，34名婴儿，15名或等于10岁及以上10岁的患者）。其中，脱离了16种手术，并在心肺旁路上进行了52种。自由的食氧脲浓度显示出1.7（0.6-4.2）mg / L的中值（四分位数范围）浓度。食氧辛素浓度的范围分别在心脏密集护理单元入院和24小时后显示出150倍和340倍的可变性。考虑到甲氧西林敏感金黄色葡萄球菌（4mg / L）和大肠杆菌（8mg / L）的Eucast断裂点，在10％的剂量间隔下的药效学（Pd）靶标在100％的剂量间隔。获得28％和16％分别患者。患者重量（差距，0.7; 95％置信区间，0.62-0.92; p = 0.006）和血清肌酐浓度（大量比例，25; 95％置信区间，18-36; p = 0.004）表现出与该有关的重要关系PD目标。结论：在儿科心脏手术后的前24小时内，食氧脲槽浓度显着变化。血清肌酐和体重都显示出与头孢洛素浓度的独立关联。无论目标细菌如何，都没有在绝大多数探索人群中获得PD目标。

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