期刊
ANTIBIOTICS-BASEL
卷 10, 期 11, 页码 -出版社
MDPI
DOI: 10.3390/antibiotics10111390
关键词
renal replacement therapy; Monte Carlo simulation; antibiotics; pharmacokinetics; pharmacodynamics
The study found that patients in lower weight quartiles tended to achieve higher antibiotic pharmacodynamic target attainment compared to heavier patients.
(1) Purpose of this study: To determine whether patient weight influences the probability of target attainment (PTA) over 72 h of initial therapy with beta-lactam (cefepime, ceftazidime, piperacillin/tazobactam) and carbapenem (imipenem, ertapenem, meropenem) antibiotics in the critical care setting. This is the first paper to address the question of whether patient size affects antibiotic PTA in the ICU. (2) Methods: We performed a post hoc analysis of Monte Carlo simulations conducted in virtual critically ill patients receiving antibiotics and continuous renal replacement therapy. The PTA was calculated for each antibiotic on the following pharmacodynamic (PD) targets: (a) were above the target organism's minimum inhibitory concentration (& GE;%fT & GE;1xMIC), (b) were above four times the MIC (& GE;%fT & GE;4xMIC), and (c) were always above the MIC (& GE;100%fT & GE;MIC) for the first 72 h of antibiotic therapy. The PTA was analyzed in patient weight quartiles [Q1 (lightest)-Q4 (heaviest)]. Optimal doses were defined as the lowest dose achieving & GE;90% PTA. (3) Results: The PTA for fT & GE;1xMIC led to similarly high rates regardless of weight quartiles. Yet, patient weight influenced the PTA for higher PD targets (100%fT & GE;MIC and fT & GE;4xMIC) with commonly used beta-lactams and carbapenems. Reaching the optimal PTA was more difficult with a PD target of 100%fT & GE;MIC compared to fT & GE;4xMIC. (4) Conclusions: The Monte Carlo simulations showed patients in lower weight quartiles tended to achieve higher antibiotic pharmacodynamic target attainment compared to heavier patients.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据