Evaluating biapenem dosage regimens in intensive care unit patients with Pseudomonas aeruginosa infections: a pharmacokinetic/pharmacodynamic analysis using Monte Carlo simulation

2018 ◽  
Vol 51 (3) ◽  
pp. 484-487 ◽  
Author(s):  
Yongfu Hang ◽  
Yafang Chen ◽  
Ling Xue ◽  
Shusen Sun ◽  
Long Liu ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Pseudomonas Aeruginosa ◽  
Monte Carlo Simulation ◽  
Monte Carlo ◽  
Intensive Care ◽  
Dosage Regimens ◽  
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.

scholarly journals Monte Carlo Simulation of Doripenem in Patients Admitted to Intensive Care Unit

2017 ◽  
Vol 39 (8) ◽  
pp. e60-e61
Author(s):  
R. Tanaka ◽  
Y. Sato ◽  
Y. Suzuki ◽  
K. Goto ◽  
N. Yasuda ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Monte Carlo Simulation ◽  
Monte Carlo ◽  
Intensive Care

scholarly journals Epidemiology and characterisation of carbapenem-non-susceptible Pseudomonas aeruginosa in a large intensive care unit in Jakarta, Indonesia

2019 ◽  
Vol 54 (5) ◽  
pp. 655-660 ◽  
Author(s):  
Yulia Rosa Saharman ◽  
Andreu Coello Pelegrin ◽  
Anis Karuniawati ◽  
Rudyanto Sedono ◽  
Dita Aditianingsih ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Pseudomonas Aeruginosa ◽  
Intensive Care

scholarly journals Mechanisms of carbapenem resistance in endemic Pseudomonas aeruginosa isolates after an SPM-1 metallo-β-lactamase producing strain subsided in an intensive care unit of a teaching hospital in Brazil

2016 ◽  
Vol 111 (9) ◽  
pp. 551-558 ◽  
Author(s):  
Luciana Camila Cacci ◽  
Stephanie Gomes Chuster ◽  
Natacha Martins ◽  
Pâmella Rodrigues do Carmo ◽  
Valéria Brígido de Carvalho Girão ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Pseudomonas Aeruginosa ◽  
Intensive Care ◽  
Teaching Hospital ◽  
Carbapenem Resistance

Recurrent Pseudomonas aeruginosa Pneumonia in an Intensive Care Unit

CHEST Journal ◽  
1992 ◽  
Vol 101 (1) ◽  
pp. 194-198 ◽  
Author(s):  
Daniel R. Silver ◽  
Ian L. Cohen ◽  
Peter F. Weinberg
Keyword(s):  
Intensive Care Unit ◽  
Pseudomonas Aeruginosa ◽  
Intensive Care
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