دورية أكاديمية
Pooled Population Pharmacokinetic Analysis and Dose Recommendations for Ciprofloxacin in Intensive Care Unit Patients with Obesity.
العنوان: | Pooled Population Pharmacokinetic Analysis and Dose Recommendations for Ciprofloxacin in Intensive Care Unit Patients with Obesity. |
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المؤلفون: | van Rhee KP; Department of Clinical Pharmacy, Tergooi MC, Hilversum, The Netherlands.; Department of Clinical Pharmacy, St Jansdal Hospital, Harderwijk, The Netherlands.; Division of Systems Biomedicine and Pharmacology, Leiden Academic Centre for Drug Research, Leiden, The Netherlands., Brüggemann RJM; Department of Pharmacy and Radboud Institute of Health Science, Radboud University Medical Center, Nijmegen, The Netherlands.; Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands., Roberts JA; University of Queensland, Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia.; Herston Infectious Diseases Institute (HeIDI), Metro North Health, Brisbane, Australia.; Departments of Pharmacy and Intensive Care Medicine, Royal Brisbane and Women's Hospital, Brisbane, Australia.; Division of Anaesthesiology Critical Care Emergency and Pain Medicine, Nîmes University Hospital, University of Montpellier, Nîmes, France., Sjövall F; Department of Intensive Care and Perioperative Medicine, Skane University Hospital, Malmö, Sweden.; Mitochondrial Medicine, Lund University, Lund, Sweden., van Hest RM; Department of Pharmacy and Clinical Pharmacology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., Elbers PWG; Department of Intensive Care Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands., Abdulla A; Department of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, The Netherlands., van der Linden PD; Department of Clinical Pharmacy, Tergooi MC, Hilversum, The Netherlands., Knibbe CAJ; Division of Systems Biomedicine and Pharmacology, Leiden Academic Centre for Drug Research, Leiden, The Netherlands.; Department of Clinical Pharmacy, St. Antonius Hospital, Nieuwegein, The Netherlands. |
المصدر: | Journal of clinical pharmacology [J Clin Pharmacol] 2024 May 12. Date of Electronic Publication: 2024 May 12. |
Publication Model: | Ahead of Print |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Wiley Country of Publication: England NLM ID: 0366372 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1552-4604 (Electronic) Linking ISSN: 00912700 NLM ISO Abbreviation: J Clin Pharmacol Subsets: MEDLINE |
أسماء مطبوعة: | Publication: 2013- : Oxford : Wiley Original Publication: Stamford, Conn., Hall Associates. |
مستخلص: | Recent studies have explored the influence of obesity and critical illness on ciprofloxacin pharmacokinetics. However, variation across the subpopulation of individuals with obesity admitted to the intensive care unit (ICU) with varying renal function remains unexamined. This study aims to characterize ciprofloxacin pharmacokinetics in ICU patients with obesity and provide dose recommendations for this special population. Individual patient data of 34 ICU patients with obesity (BMI >30 kg/m 2 ) from four studies evaluating ciprofloxacin pharmacokinetics in ICU patients were pooled and combined with data from a study involving 10 individuals with obesity undergoing bariatric surgery. All samples were collected after intravenous administration. Non-linear mixed effects modeling and simulation were used to develop a population pharmacokinetic model and describe ciprofloxacin exposure in plasma. Model-based dose evaluations were performed using a pharmacokinetic/pharmacodynamic target of AUC/MIC >125. The data from patients with BMI ranging from 30.2 to 58.1 were best described by a two-compartment model with first-order elimination and a proportional error model. The inclusion of Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) as a covariate on clearance reduced inter-individual variability from 57.3% to 38.5% (P < .001). Neither body weight nor ICU admission significantly influenced clearance or volume of distribution. Renal function is a viable predictor for ciprofloxacin clearance in ICU patients with obesity, while critical illness and body weight do not significantly alter clearance. As such, body weight and critical illness do not need to be accounted for when dosing ciprofloxacin in ICU patients with obesity. Individuals with CKD-EPI >60 mL/min/1.73 m 2 may require higher dosages for the treatment of pathogens with minimal inhibitory concentration ≥0.25 mg/L. (© 2024 The Authors. The Journal of Clinical Pharmacology published by Wiley Periodicals LLC on behalf of American College of Clinical Pharmacology.) |
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فهرسة مساهمة: | Keywords: ICU patients; ciprofloxacin; dosing; obesity; pharmacokinetics |
تواريخ الأحداث: | Date Created: 20240512 Latest Revision: 20240512 |
رمز التحديث: | 20240513 |
DOI: | 10.1002/jcph.2450 |
PMID: | 38736038 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1552-4604 |
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DOI: | 10.1002/jcph.2450 |