Adequate plasma drug concentrations suggest that amoxicillin can be administered by continuous infusion using elastomeric pumps.

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Version: Author's accepted manuscript
License: All rights reserved
Serval ID
serval:BIB_3070E2D569A0
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Adequate plasma drug concentrations suggest that amoxicillin can be administered by continuous infusion using elastomeric pumps.
Journal
The Journal of antimicrobial chemotherapy
Author(s)
Arensdorff L., Boillat-Blanco N., Decosterd L., Buclin T., de Vallière S.
ISSN
1460-2091 (Electronic)
ISSN-L
0305-7453
Publication state
Published
Issued date
01/09/2017
Peer-reviewed
Oui
Volume
72
Number
9
Pages
2613-2615
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Elastomeric pumps can be useful for the administration of antibiotics in the outpatient setting.
To determine amoxicillin degradation in elastomeric pumps, as well as the effectiveness of amoxicillin treatment administered by elastomeric pumps.
Antibiotic degradation was measured in elastomeric pumps filled with 6 g of amoxicillin in 240 mL of NaCl 0.9% by drawing samples at 12 h intervals when stored in the fridge for 48 h and when worn around the waist for 24 h. Subsequently nine patients were treated with continuous infusions of 8 or 12 g of amoxicillin per day. Plasma amoxicillin concentrations were measured on each visit to the outpatient parenteral antibiotic therapy unit. Clinical outcome was verified 3 months after the end of treatment.
Amoxicillin degradation in elastomeric pumps reached 10% after 48 h in the fridge and an additional 30% when worn around the waist for 24 h. Mean plasma drug concentrations achieved with 12 g of amoxicillin per day were 18.5 mg/L (95% CI 13.5-23.5), which is largely above the MIC of amoxicillin-susceptible bacteria. Nine patients treated for various complicated infections were cured and had no unexpected adverse effects.
Adequate plasma drug concentrations and favourable clinical outcomes suggest that amoxicillin can be administered by continuous infusion using elastomeric pumps. This treatment modality does not fulfil formal requirements regarding pharmaceutical stability, but the resulting safety impact in patients is probably limited. Therapeutic drug monitoring and a close clinical follow-up are recommended if this route of administration is chosen.

Keywords
Adult, Aged, Aged, 80 and over, Amoxicillin/administration & dosage, Amoxicillin/blood, Anti-Bacterial Agents/administration & dosage, Anti-Bacterial Agents/blood, Equipment Design, Female, Humans, Infusion Pumps, Infusions, Intravenous/instrumentation, Infusions, Intravenous/methods, Male, Middle Aged, Outpatients
Pubmed
Web of science
Open Access
Yes
Create date
22/06/2017 18:17
Last modification date
20/08/2019 14:15
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