Δευτέρα 8 Μαΐου 2017

Population pharmacokinetics and dosing simulations of ceftazidime in critically ill patients receiving sustained low-efficiency dialysis

<span class="paragraphSection"><strong>Objectives:</strong> To describe the population PKs of ceftazidime in critically ill patients receiving sustained low-efficiency dialysis (SLED).<strong>Patients and methods:</strong> This study was performed in ICUs of a university hospital. We collected blood samples during three consecutive days of SLED sessions in patients receiving ceftazidime. Concentration versus time curves were analysed using a population PKs approach with Pmetrics<sup>®</sup>. Monte Carlo simulation for the first 24 h including a 6 h SLED session was performed with the final model. The fractional target attainment against the MIC of <span style="font-style:italic;">Pseudomonas aeruginosa</span> was executed using targets of 50 and 100% <span style="font-style:italic;">fT </span><sub>></sub><span style="font-style:italic;"> </span><sub>MIC</sub>.<strong>Results:</strong> In total, 211 blood samples of 16 critically ill patients under SLED were collected. SLED treatments were 299.3 (68.4) min in duration. A two-compartment linear population PK model was most appropriate. The mean (SD) CL of ceftazidime on SLED, and off SLED were 5.32 (3.2), 1.06 (1.0) L/h respectively. The PTA for 50% <span style="font-style:italic;">fT </span><sub>></sub><span style="font-style:italic;"> </span><sub>MIC</sub> for a dose of 1 g intravenously every 8 h was 98%. Assuming a target of 100% <span style="font-style:italic;">fT </span><sub>></sub><span style="font-style:italic;"> </span><sub>MIC</sub> a dose of 2 g every 12 h covers isolates with MIC ≤8 mg/L with a PTA of 96%.<strong>Conclusion:</strong> In critically ill patients receiving SLED, ceftazidime 1 g every 8 h and ceftazidime 2 g every 12 h appear to be sufficient for achieving traditional (50% <span style="font-style:italic;">fT </span><sub>></sub><span style="font-style:italic;"> </span><sub>MIC</sub>) and aggressive PD targets (100% <span style="font-style:italic;">fT </span><sub>></sub><span style="font-style:italic;"> </span><sub>MIC</sub>) for susceptible isolates (MIC ≤8 mg/L), respectively.</span>

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