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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&gt;MIC, 40%fT&gt;MIC and 100%fT&gt;MIC. For the target of 40%fT&gt;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&gt;MIC target, only continuous infusion was associated with nearly optimal exposures. Higher PTAs for the targets of 40%fT&gt;MIC and 100%fT&gt;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