Ceftazidime therapeutic drug monitoring in patients with melioidosis

Melioidosis is an infectious disease typically treated with prolonged intravenous ceftazidime infusion. This study examined the utility of therapeutic drug monitoring (TDM) of ceftazidime in 122 patients with confirmed melioidosis at an Australian hospital. Patients were divided into two groups: 31 received intermittent ceftazidime dosing and 91 received continuous infusion. Results showed that the median concentration-to-MIC ratio was 37.7 for intermittent dosing and 47.5 for continuous infusion. Neurotoxicity occurred in 16% of patients receiving intermittent dosing and 4% receiving continuous infusion. Higher ceftazidime concentrations were associated with increased mortality. Current dosing recommendations achieve ceftazidime concentrations far exceeding required levels, suggesting that monitoring could help reduce doses and lower toxicity risk.