Is continuous infusion of imipenem always the best choice?
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F61989592%3A15110%2F17%3A73580196" target="_blank" >RIV/61989592:15110/17:73580196 - isvavai.cz</a>
Alternative codes found
RIV/00216208:11110/17:10362153 RIV/00098892:_____/17:N0000041 RIV/00064165:_____/17:10362153
Result on the web
<a href="http://dx.doi.org/10.1016/j.ijantimicag.2016.12.005" target="_blank" >http://dx.doi.org/10.1016/j.ijantimicag.2016.12.005</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1016/j.ijantimicag.2016.12.005" target="_blank" >10.1016/j.ijantimicag.2016.12.005</a>
Alternative languages
Result language
angličtina
Original language name
Is continuous infusion of imipenem always the best choice?
Original language description
Monte Carlo simulations allow prediction and comparison of concentration–time profiles arising from different dosing regimens in a defined population, provided a population pharmacokinetic model has been established. The aims of this study were to evaluate the population pharmacokinetics of imipenem in critically ill patients with hospital-acquired pneumonia (HAP) and to assess the probability of target attainment (PTA) and cumulative fraction of response (CFR) using EUCAST data. A two-compartment model based on a data set of 19 subjects was employed. Various dosage regimens at 0.5-h and 3-h infusion rates and as continuous infusion were evaluated against the pharmacodynamic targets of 20%fT>MIC, 40%fT>MIC and 100%fT>MIC. For the target of 40%fT>MIC, all 0.5-h infusion regimens achieved optimal exposures (CFR ≥ 90%) against Escherichia coli and Staphylococcus aureus,with nearly optimal exposure against Klebsiella pneumoniae (CFR ≥ 89.4%). The 3-h infusions and continuous infusion exceeded 97% CFR against all pathogens with the exception of Pseudomonas aeruginosa and Acinetobacter spp., where the maximum CFRs were 85.5% and 88.4%, respectively. For the 100%fT>MIC target, only continuous infusion was associated with nearly optimal exposures. Higher PTAs for the targets of 40%fT>MIC and 100%fT>MIC were achieved with 3-h infusions and continuous infusion in comparison with 0.5-h infusions; however, continuous infusion carries a risk of not reaching the MIC of less susceptible pathogens in a higher proportion of patients. In critically ill patients with HAP with risk factors for Gram-negative non-fermenting bacteria, maximum doses administered as extended infusions may be necessary.
Czech name
—
Czech description
—
Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
—
OECD FORD branch
30104 - Pharmacology and pharmacy
Result continuities
Project
—
Continuities
S - Specificky vyzkum na vysokych skolach
Others
Publication year
2017
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
International Journal of Antimicrobial Agents
ISSN
0924-8579
e-ISSN
—
Volume of the periodical
2017
Issue of the periodical within the volume
49
Country of publishing house
NL - THE KINGDOM OF THE NETHERLANDS
Number of pages
7
Pages from-to
348-354
UT code for WoS article
000397148100013
EID of the result in the Scopus database
2-s2.0-54349096816