Retrospective evaluation of appropriate dosing of cefmetazole for invasive urinary tract infection due to extended-spectrum β-lactamase-producing Escherichia coli. Issue 11 (November 2021)

• Record Type: Journal Article
• Authors: Hamada, Yukihiro; Matsumura, Yasufumi; Nagashima, Maki; Akazawa, Tsubasa; Doi, Yohei; Hayakawa, Kayoko
• Is Part Of: Journal of infection and chemotherapy. Volume 27:Issue 11(2021)
• Page Start: 1602
• Page End: 1606
• Publication Date: 2021-11
• Subjects: Urinary tract infections -- Extended-spectrum β-lactamase -- Enterobacterales -- Escherichia coli -- Cefmetazole; UTI urinary tract infections -- iUTI invasive UTI -- ESBL extended-spectrum β-lactamase -- ESBL-E ESBL-producing Enterobacterales -- ESBLEC ESBL-producing Escherichia coli -- CMZ cefmetazole -- IQR interquartile range -- MIC minimum inhibitory concentration -- TAM time above MIC -- PK/PD pharmacokinetic/pharmacodynamic -- ClCr creatinine clearance -- E-R exposure–response; Chemotherapy -- Periodicals; Infection -- Periodicals; Communicable diseases -- Chemotherapy -- Periodicals; 615.5805
• DOI: 10.1016/j.jiac.2021.07.009
• Languages: English
• ISSNs: 1341-321X

Abstract

Abstract: Introduction: The frequency of urinary tract infections (UTIs) caused by extended-spectrum β-lactamase (ESBL)-producing Enterobacterales is steadily increasing worldwide. Therefore, we aimed to evaluate the efficacy and appropriate dosing of cefmetazole (CMZ) in invasive urinary tract infection (iUTI) caused by ESBL-producing Escherichia coli (ESBLEC). Methods: Patients who developed ESBLEC iUTI and received CMZ between January 2007 and December 2018 were identified, and their medical records were reviewed. The time above minimum inhibitory concentration (MIC) (TAM) was calculated using the MIC value obtained from each patient and its simulated CMZ concentration. Results: Thirty-nine patients were included in the study. The median TAM was 92.6% (interquartile range [IQR], 67.6–100). CMZ was clinically efficacious in 38 (97.4%) patients overall and in 11 out of 12 (91.7%) patients with normal renal function who received CMZ at 1 g every 8 h. Conclusions: In normal renal function, 1 g CMZ infused for over 1 h every 8 h is an efficacious treatment for iUTI caused by ESBLEC with MIC =< 4 mg/L.