Population pharmacokinetics of meropenem in critically ill patients

IF 1.7 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Open Medicine Pub Date : 2024-07-22 DOI:10.1515/med-2024-1004

Aleksandar Rančić, Miloš N. Milosavljević, Nikola Rosić, Dragan Milovanović, Marko Folić, Dejana Ružić Zečević, Nemanja Petrović, Mirjana Milojević Čorbić, Vera Dabanović, Slobodan M. Janković

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引用次数: 0

Abstract

Objective The pharmacokinetics of meropenem are significantly altered in critically ill patients. A population pharmacokinetic study was designed to estimate typical values of meropenem clearance in critically ill patients and evaluate potential factors of influence. Methods After meropenem reached a steady state in each patient, two blood samples were taken within the dose interval. The one-compartment pharmacokinetic model based on the data from 101 intensive care unit patients was built using NONMEM software. Results Typical values of meropenem clearance and volume of distribution were 3.80 L/h and 3.52 L, respectively. In the final model, meropenem clearance was influenced by serum concentrations of creatinine (CRE), leukocyte count (WBC), hypertension (HTA), and concomitant use of vancomycin (VAN) or colistimethate (COL): CL (L/h) = 5.29 × CRE ^ 0.000001 × WBCs ^ (−0.165) + 0.000001 × HTA + 0.825 × VAN + 1.28 × COL. Conclusion In order to achieve effective plasma concentrations of meropenem in critically ill patients, the meropenem dosing regimen should be adjusted according to individual values of drug clearance.

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重症患者体内美罗培南的群体药代动力学

目的重症患者体内美罗培南的药代动力学会发生显著变化。我们设计了一项群体药代动力学研究，以估算重症患者美罗培南清除率的典型值，并评估潜在的影响因素。方法在每位患者的美罗培南达到稳定状态后，在剂量间隔内采集两次血样。使用 NONMEM 软件根据 101 例重症监护室患者的数据建立了单室药代动力学模型。结果美罗培南清除率和分布容积的典型值分别为 3.80 L/h 和 3.52 L。在最终模型中，美罗培南清除率受血清肌酐浓度（CRE）、白细胞计数（WBC）、高血压（HTA）以及同时使用万古霉素（VAN）或可乐定（COL）的影响：CL (L/h) = 5.29 × CRE ^ 0.000001 × WBCs ^ (-0.165) + 0.000001 × HTA + 0.825 × VAN + 1.28 × COL。结论为了使重症患者体内的美罗培南达到有效的血浆浓度，应根据药物清除率的个体值调整美罗培南的给药方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Open Medicine Medicine-General Medicine

CiteScore

3.00

自引率

0.00%

发文量

153

审稿时长

20 weeks

期刊介绍： Open Medicine is an open access journal that provides users with free, instant, and continued access to all content worldwide. The primary goal of the journal has always been a focus on maintaining the high quality of its published content. Its mission is to facilitate the exchange of ideas between medical science researchers from different countries. Papers connected to all fields of medicine and public health are welcomed. Open Medicine accepts submissions of research articles, reviews, case reports, letters to editor and book reviews.