Examination of the Clinically Effective Dose of Cefmetazole and the Validity of Dose Adjustment Using the Giusti-Hayton Method

Abstract

Cefmetazole (CMZ) is a widely used antimicrobial agent against various infectious diseases. Few studies have determined the appropriate daily dose, and the dose adjustment criteria based on renal function are unclear. Therefore, this study evaluated the clinically effective dose of CMZ and the validity of dose adjustment using the Giusti-Hayton (G-H) method. Patients who received CMZ at Ebara Hospital from April 2019 to March 2021 were included. The basic daily dose was set at 4 g, which is the maximum dose approved in Japan, and a dose adjustment standard table was prepared with variables calculated using the G-H method. The patients were grouped according to whether their dosage of CMZ was adjusted using G-H method or not into the G-H and non-G-H groups. We set the primary endpoints as the efficacy and safety of CMZ, and the secondary endpoint as the pharmacokinetics/pharmacodynamics parameter (PK/PD parameter). There were 107 and 99 target cases in the G-H and non-G-H groups, respectively. The G-H group included several elderly people with a poor prognosis for infectious diseases; however, there was no significant difference in the efficacy and safety of CMZ between the groups. The time above MIC was significantly higher in the G-H group. Therefore, dose adjustment using the G-H method, based on a dose of 4 g/day, can be useful in terms of PK/PD parameters. Moreover, it has been shown to be highly effective and safe. Thus, the results of this study may help in determining the dose and dose adjustment of CMZ.