Probenecid, an old β-lactams pharmacokinetic enhancer for a renewed use: A retrospective study - 30/07/22
Highlights |
• | Thirty-eight patients who received probenecid with β-lactam antibiotic to treat a systemic infection were retrospectively investigated. |
• | Probenecid induced an increase in ATC in 18/19 patients (94.7%), with a median (IQR) change of 228.4% (IQR 38.7–633). |
Abstract |
Background |
Optimized antibiotic plasma predictor efficacy is essential in systemic infections. The uricosuric agent probenecid inhibits tubular excretion of antibiotics and may be used as β-lactam pharmacokinetic enhancer (BLPKE), even though few data are currently available for this purpose.
Methods |
We conducted a monocentric and retrospective observational study including all patients who received probenecid in combination with parenteral β-lactam antibiotics for systemic infections from Jan 1, 2014 to Dec 31, 2019. Demographics, infection characteristics, treatment and ATC (antibiotics trough concentration) were investigated.
Results |
All in all, 38 patients were included. Eight patients had a history of sickle cell disease. Hyperfiltration (defined as eGFR>130mL/min/1.73m2) was detected in twenty-one patients including six with sickle cell disease. Probenecid (500mg q6h orally) was added to antibiotics for a median (IQR) of 13 days (6.75–21.75), after a median (IQR) time lapse of 7 days (4–16) following the initiation of antibiotics. Probenecid was administered for low antibiotic trough concentration in 29 patients, for increased renal clearance in 5 patients and for persisting fever despite antibiotic therapy in 4 patients (including 1 infective relapse). A second plasma trough concentration, following probenecid administration, was available in 19 patients within a median (IQR) 3 days (2–5). Probenecid induced increased ATC in 18/19 patients (94.7%), with a median (IQR) change of +228.4% (IQR 38.7–633). No major adverse effects were reported.
Conclusion |
Probenecid could be a BLPKE. Our data suggest this drug should be used more often to optimize β-lactam pharmacokinetics in clinical practice.
Le texte complet de cet article est disponible en PDF.Keywords : Antibiotic, Pharmacokinetics, Probenecid, Renal hyperfiltration
Plan
Vol 52 - N° 5
P. 273-279 - août 2022 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?