Scientific Poster Session III - Original Research

Original Research
  Monday, October 14, 2024
  01:00 PM–02:30 PM

Abstract

Introduction: Data regarding the efficacy of cefepime in treating patients with Pseudomonas aeruginosa (PSA) infections undergoing renal replacement therapies (RRT) are limited.

Research Question or Hypothesis: Is cefepime effective at recommended dosing in treating patients with PSA infections undergoing RRT?

Study Design: Retrospective observational cohort study.

Methods: The study was conducted between May 2015 and December 2022. The primary end point was 30-day all-cause mortality. Secondary endpoints including clinical cure, microbiologic cure, infection recurrence rate, and incidence of adverse events.

Results: A total of 132 patients met the inclusion criteria, with a 72.7% survival rate. Of these, 81 (62.4%) were male, with a median age of 69 years and a median BMI of 27 kg/m². The most common diagnoses were pneumonia (58.3%), followed by bacteremia (18.9%). The median minimum inhibitory concentration of cefepime for PSA was 2 mcg/mL. The median daily dose of cefepime was 4000 mg during continuous venovenous hemofiltration (CVVH) and 1000 mg during intermittent hemodialysis (IHD), with a median duration of therapy of 8 days. The 30-day survival rate was 72.7%, clinical cure was achieved in 58.3% of subjects, and microbiologic cure in 31%. The 30-day reinfection rate was 9.1%, with no documented adverse events associated with the doses used. Multivariate logistic regression analysis identified the use of vasopressors (OR 4.6, 95% CI 1.251-17.1) and white blood cell (WBC) level at the end of therapy (OR 1.1, 95% CI 1.01-1.4) as the main predictors of all-cause mortality in this population.

Conclusion: Our results suggest that the utilized doses of cefepime in patients with PSA infections undergoing RRT were effective and safe. Larger studies are needed to confirm our findings.

Presenting Author

Wasim Elnekidy PharmD, BCPS, BCACP
Cleveland Clinic Abu Dhabi

Authors

Emna Abidi PhD
Cleveland Clinic Abu Dhabi

Khaled Al Zaman MD
University of Sharjah

Ali Almheiri MD
Cleveland Clinic Abu Dhabi

Amna Alshamsi MD
Cleveland Clinic Abu Dhabi

Rania El Lababidi PharmD, BCPS (AQ-ID), AAHIVP
Cleveland Clinic Abu Dhabi

Islam Ghazi PharmD
Arnold and Marie Schwartz College of Pharmacy

Muriel Ghosn MD
Cleveland Clinic Abu Dhabi

Khaled Ismail MD
Cleveland Clinic Abu Dhabi

Amir Malik MD
Cleveland Clinic Abu Dhabi

Jihad Mallat MD
Cleveland Clinic Abu Dhabi

Mohamad Mooty MD
Cleveland Clinic Abu Dhabi