Empiric therapy for secondary peritonitis: A pharmacodynamic analysis of cefepime, ceftazidime, ceftriaxone, imipenem, levofloxacin, piperacillin/tazobactam, and tigecycline using Monte Carlo simulation

2007 ◽  
Vol 29 (5) ◽  
pp. 889-899 ◽  
Author(s):  
Kathryn J. Eagye ◽  
Joseph L. Kuti ◽  
Michael Dowzicky ◽  
David P. Nicolau
Keyword(s):  
Monte Carlo Simulation ◽  
Monte Carlo ◽  
Empiric Therapy ◽  
Secondary Peritonitis ◽  
Pharmacodynamic Analysis

Pharmacokinetic/pharmacodynamic analysis by Monte Carlo simulation of cefquinome in llamas, following intravenous, intramuscular and subcutaneous administration in serum and tissue cage fluid

2017 ◽  
Vol 149 ◽  
pp. 134-140
Author(s):  
Martin Alejandro Himelfarb ◽  
Augusto Matias Lorenzutti ◽  
Nicolás Javier Litterio ◽  
María del Pilar Zarazaga ◽  
María Soledad Aguilar-Sola ◽  
...  
Keyword(s):  
Monte Carlo Simulation ◽  
Monte Carlo ◽  
Subcutaneous Administration ◽  
Pharmacodynamic Analysis

scholarly journals Pharmacokinetic/pharmacodynamic analysis of weight- and height-scaled tobramycin dosage regimens for patients with cystic fibrosis

2019 ◽  
Vol 74 (8) ◽  
pp. 2311-2317
Author(s):  
S S Alghanem ◽  
D J Touw ◽  
A H Thomson
Keyword(s):  
Cystic Fibrosis ◽  
Pseudomonas Aeruginosa ◽  
Monte Carlo Simulation ◽  
Monte Carlo ◽  
Simulated Dataset ◽  
Dosage Regimens ◽  
Pharmacodynamic Analysis ◽  
Dosing Regimens ◽  
Lower Height ◽  
Higher Doses

Abstract Objectives To determine the outcomes of weight- and height-based tobramycin dosing regimens for patients with cystic fibrosis (CF). Methods A simulated dataset of 5000 patients based on 331 patients with CF was created using NONMEM. Pharmacokinetic (PK) parameters were derived for each patient from a published model using Monte Carlo simulation. The abilities of 10 and 12 mg/kg/day and 3 and 4 mg/cm/day to achieve standard and extended Cmax (20–30 and 20–40 mg/L) and AUC0–24 (80–120 and 80–150 mg·h/L) targets were evaluated. PK/pharmacodynamic (PK/PD) indices were a Cmax/MIC ratio ≥10 and an AUC0–24/MIC ratio ≥110. For these indices and a range of MICs, cumulative fractions of response (CFRs) for Pseudomonas aeruginosa were also determined. Results More patients achieved standard Cmax and AUC0–24 targets with 3 mg/cm/day (64% and 62%, respectively) than with 10 mg/kg/day (43% and 48%, respectively). AUC0–24 estimates >120 mg·h/L were more common with weight-based dosing. With higher doses, 72% achieved high target peaks with 4 mg/cm/day and 65% with 12 mg/kg/day. For the Cmax/MIC index, the maximal MIC for the target microorganism was 2 mg/L with lower doses, 2.5 mg/L with higher doses and 0.5 mg/L for AUC0–24/MIC-based regimens. The CFR for all regimens was >90% for Cmax targets and 66% to 79% for AUC0–24 targets. Conclusions A tobramycin dose of 3 mg/cm/day rather than 10 mg/kg/day achieved similar PK/PD outcomes but dose and AUC0–24 ranges were narrower and the incidence of high AUC0–24 values was lower. Height-based doses should therefore be considered for patients with CF.

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