The use of doripenem in pediatric cystic fibrosis patients in case of meropenem shortages

Pediatr Pulmonol. 2014 Mar;49(3):E48-51. doi: 10.1002/ppul.22798. Epub 2013 May 9.

Abstract

Ceftazidime is the only anti-pseudomonal beta-lactam that has been reported to be administered by extended infusion in pediatric cystic fibrosis (CF) patients. A small pediatric pharmacokinetic/pharmacodynamic study has been published regarding the use of intermittent extended infusion doripenem in the treatment of an acute pulmonary exacerbation (APE) in pediatric CF patients; however, clinical use of intermittent extended infusion doripenem in pediatric CF patients has not been previously reported. We present three cases administering intermittent extended infusion doripenem in pediatric CF patients for the treatment of an APE in the case of replacing meropenem due to shortage. The delivery of beta-lactam antibiotics via intermittent extended infusion should be considered in order to optimize the pharmacodynamics of beta-lactams in the treatment of an APE.

Keywords: Burkholderia cenocepacia; Inquilinus limosus; Pseudomonas aeruginosa; antibiotics; beta-lactams.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anti-Bacterial Agents / supply & distribution
  • Anti-Bacterial Agents / therapeutic use*
  • Burkholderia Infections / complications
  • Burkholderia Infections / drug therapy*
  • Burkholderia cenocepacia / isolation & purification
  • Carbapenems / therapeutic use*
  • Child
  • Cystic Fibrosis / complications
  • Cystic Fibrosis / drug therapy*
  • Cystic Fibrosis / microbiology
  • Disease Progression
  • Doripenem
  • Drug Therapy, Combination
  • Female
  • Gram-Negative Bacterial Infections / complications
  • Gram-Negative Bacterial Infections / drug therapy
  • Humans
  • Infusions, Intravenous
  • Meropenem
  • Pseudomonas Infections / complications
  • Pseudomonas Infections / drug therapy*
  • Pseudomonas aeruginosa / isolation & purification
  • Pseudomonas stutzeri / isolation & purification
  • Rhodospirillaceae / isolation & purification
  • Thienamycins / supply & distribution
  • Tobramycin / therapeutic use
  • Treatment Outcome
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Carbapenems
  • Thienamycins
  • Trimethoprim, Sulfamethoxazole Drug Combination
  • Doripenem
  • Meropenem
  • Tobramycin