Prospective monitoring of cefepime in intensive care unit adult patients

Table 1 Clinical and microbiological features of the study population (10 females and 11 males; median age 55.1 years, range 21.8 to 81.2)

Reason for ICU admission	Underlying disease	SAPS II score	Weight (Kg)	Cl_Cr	Presumed pathogens	MIC (mg/l)
Cardiovascular surgery ¹	Coronary artery disease	38	75	17.8
Multiple trauma	Bipolar disorder	33	75	139.3	E. coli	0.024
Thoracic surgery ²	Non-specific interstitial pneumonia	33	85	126.6
Abdominal surgery ³	Abdominal aortic aneurysms	26	75	51
Multiple trauma	Chronic obstructive pulmonary disease	23	86	63.4	S. aureus	2
Abdominal surgery	Abdominal aortic aneurysms	32	85	32.9
Cardiovascular surgery	Aortic stenosis	47	63	62.2
Acute respiratory failure ⁴	Obesity stage II	24	120	135.5	S. pneumoniae	0.75
Neurosurgery	Cerebral arterio-venous malformation	50	53	166.9	E. coli	0.04
Cardiovascular surgery	Myeloproliferative disorder	52	65	79.6	S. pneumoniae	0.047
Multiple trauma	None	42	70	133.5	P. aeruginosa	4
Cardiovascular surgery	Aortic bicuspidy	9	68	101.9
Acute respiratory failure ¹	Coronary artery disease	51	60	12
Neurosurgery	None	23	40	161	P. aeruginosa	4
Multiple trauma	Diabetes mellitus	22	58	92.1
Cardiovascular surgery	Coronary artery disease	24	78	59.8
Acute respiratory failure ⁴	Myeloproliferative disorder	69	52	95.5	S. pneumoniae	1
Cardiovascular surgery	Coronary artery disease	33	47	115.1
Multiple trauma	None	24	62	142.1
Ear-nose and throat surgery	Pharynx carcinoma	43	60	87.7
Neurosurgery	High blood pressure	58	100	121.8	H. influenzae	1

Cl_Cr, creatinine clearance at inclusion, as determined by the Cockcroft-Gault equation; E. coli, Escherichia coli; H. influenza, Haemophilus influenza; MIC, minimal inhibitory concentration; P. aeruginosa, Pseudomonas aeruginosa; S. aureus, Staphylococcus aureus;S. pneumonia, Streptococcus pneumoniae;
¹Patients who developed drug accumulation and symptoms compatible with neurological toxicity.
²Patient suffering a further episode of bronchoaspiration; switched to amoxicillin-clavulanate during follow-up.
³Patient died eight days after leaving the ICU from multiorgan failure. Autopsy revealed an ischemic colitis with intra-abdominal steatonecrosis. Patient was also treated with metronidazole for the presence of Clostridium difficile in stool cultures.
⁴Patients eventually switched to levofloxacin as a treatment of choice of penicillin intermediate-resistant Streptococcus pneumoniae.

ISSN: 1364-8535