Is continuous infusion of imipenem always the best choice?

Kód výsledku v 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>

Nalezeny alternativní kódy

RIV/00216208:11110/17:10362153 RIV/00098892:_____/17:N0000041 RIV/00064165:_____/17:10362153

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

Is continuous infusion of imipenem always the best choice?

Popis výsledku v původním jazyce

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.

Název v anglickém jazyce

Is continuous infusion of imipenem always the best choice?

Popis výsledku anglicky

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.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30104 - Pharmacology and pharmacy

Projekt

—

Návaznosti

S - Specificky vyzkum na vysokych skolach

Rok uplatnění

2017

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

International Journal of Antimicrobial Agents

ISSN

0924-8579

e-ISSN

—

Svazek periodika

2017

Číslo periodika v rámci svazku

49

Stát vydavatele periodika

NL - Nizozemsko

Počet stran výsledku

7

Strana od-do

348-354

Kód UT WoS článku

000397148100013

EID výsledku v databázi Scopus

2-s2.0-54349096816