...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>The Journal of Clinical Pharmacology: Official Journal of the American College of Clinical Pharmacology >A Monte Carlo Simulation Approach for Beta‐Lactam Dosing in Critically Ill Patients Receiving Prolonged Intermittent Renal Replacement Therapy
【24h】

A Monte Carlo Simulation Approach for Beta‐Lactam Dosing in Critically Ill Patients Receiving Prolonged Intermittent Renal Replacement Therapy

机译：一种蒙特卡罗仿真方法，用于治疗近期间歇性肾替代治疗

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Abstract Cefepime, ceftazidime, and piperacillin/tazobactam are commonly used beta‐lactam antibiotics in the critical care setting. For critically ill patients receiving prolonged intermittent renal replacement therapy (PIRRT), limited pharmacokinetic data are available to inform clinicians on the dosing of these agents. Monte Carlo simulations (MCS) can be used to guide drug dosing when pharmacokinetic trials are not feasible. For each antibiotic, MCS using previously published pharmacokinetic data derived from critically ill patients was used to evaluate multiple dosing regimens in 4 different prolonged intermittent renal replacement therapy effluent rates and prolonged intermittent renal replacement therapy duration combinations (4?L/h?×?10?hours or 5 L/h?×?8?hours in hemodialysis and hemofiltration modes). Antibiotic regimens were also modeled depending on whether drugs were administered during or well before prolonged intermittent renal replacement therapy therapy commenced. The probability of target attainment (PTA) was calculated using each antibiotic's pharmacodynamic target during the first 48?hours of therapy. Optimal doses were defined as the smallest daily dose achieving ≥90% probability of target attainment in all prolonged intermittent renal replacement therapy effluent and duration combinations. Cefepime 1?g every 6?hours following a 2?g loading dose, ceftazidime 2?g every 12?hours, and piperacillin/tazobactam 4.5?g every 6?hours attained the desired pharmacodynamic target in ≥90% of modeled prolonged intermittent renal replacement therapy patients. Alternatively, if an every 6‐hours cefepime regimen is not desired, the cefepime 2?g pre‐prolonged intermittent renal replacement therapy and 3?g post‐prolonged intermittent renal replacement therapy regimen also met targets. For ceftazidime, 1?g every 6?hours or 3?g continuous infusion following a 2?g loading dose also met targets. These recommended doses provide simple regimens that are likely to achieve the pharmacodynamics target while yielding the least overall drug exposure, which should result in lower toxicity rates. These findings should be validated in the clinical setting.
机译：摘要Cefepime，头孢唑胺和哌啶/ Tazobactam通常在关键护理环境中使用β-内酰胺抗生素。对于接受延长间歇性肾置换疗法（PIRRT）的患者，有限的药代动力学数据可用于通知临床医生对这些药剂的给药。当药代动力学试验不可行时，蒙特卡罗模拟（MCS）可用于引导药物给药。对于每种抗生素，使用先前公布的药代动力学数据源自危重病症的药代动力学数据，用于评估4种不同的延长间歇性肾置换疗法出水率和延长间歇性肾置换治疗持续时间组合的多剂量方案（4？L / H？×10 ？血液透析和血液过滤模式中的小时或5升/小时？×8？小时）。抗生素方案也取决于药物是否在延长间歇性肾替代治疗疗法期间或良好施用。使用每种抗生素的药效学靶标在前48小时的治疗疗法计算靶培养（PTA）的可能性。最佳剂量被定义为最小的每日剂量，在所有延长间歇性肾置换治疗废水和持续时间组合中达到≥90％的目标达到概率。每6个？每6小时一次替代治疗患者。或者，如果不需要每6小时的头孢隙方案，则头孢齿2？G延长间歇性间歇肾置换治疗和3μl延长后间歇性肾置换治疗方案也符合目标。对于头孢他啶，每6小时1？G？小时或3·克连续输注在2？G加载剂量后也达到目标。这些推荐剂量提供了很简单的方案，该方案可能在产生药效流学靶点的同时，同时产生最少的整体药物暴露，这应该导致毒性较低。这些调查结果应在临床环境中验证。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号