Population Pharmacokinetics and Dose Optimization of Teicoplanin during Venoarterial Extracorporeal Membrane Oxygenation
| العنوان: | Population Pharmacokinetics and Dose Optimization of Teicoplanin during Venoarterial Extracorporeal Membrane Oxygenation |
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| المؤلفون: | Kyoung Lok Min, Soo Kyung Bae, Min Jung Chang, Seungwon Yang, Donghoon Choi, Byung Hak Jin, Jin Wi, Min Soo Park, Jongsung Hahn, Hayeon Noh, Jiseon Kim |
| المصدر: | Antimicrobial Agents and Chemotherapy. 61 |
| بيانات النشر: | American Society for Microbiology, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Adult, Male, 0301 basic medicine, Critical Illness, medicine.medical_treatment, 030106 microbiology, Population, Heart Valve Diseases, Myocardial Infarction, Shock, Cardiogenic, Clinical Therapeutics, Loading dose, Young Adult, 03 medical and health sciences, Extracorporeal Membrane Oxygenation, 0302 clinical medicine, Pharmacokinetics, medicine, Extracorporeal membrane oxygenation, Humans, Pharmacology (medical), Prospective Studies, Renal replacement therapy, education, Aged, Pharmacology, Volume of distribution, education.field_of_study, Maintenance dose, Teicoplanin, business.industry, 030208 emergency & critical care medicine, Middle Aged, Anti-Bacterial Agents, Renal Replacement Therapy, Myocarditis, Infectious Diseases, Mycoses, Anesthesia, Female, business, Monte Carlo Method, medicine.drug |
| الوصف: | The pharmacokinetics (PK) of drugs are known to be significantly altered in patients receiving extracorporeal membrane oxygenation (ECMO). However, clinical studies of the PK of drugs administered during ECMO are scarce, and the proper dosing adjustment has yet to be established. We developed a population PK model for teicoplanin, investigated covariates influencing teicoplanin exposure, and suggested an optimal dosing regimen for ECMO patients. Samples for PK analysis were collected from 10 adult patients, and a population PK analysis and simulations were performed to identify an optimal teicoplanin dose needed to provide a >50% probability of target attainment at 72 h using a trough concentration target of >10 μg/ml for mild to moderate infections and a trough concentration target of >15 μg/ml for severe infections. Teicoplanin was well described by a two-compartment PK model with first-order elimination. The presence of ECMO was associated with a lower central volume of distribution, and continuous renal replacement therapy (CRRT) was associated with a higher peripheral volume of distribution. For mild to moderate infections, an optimal dose was a loading dose (LD) of 600 mg and a maintenance dose (MD) of 400 mg for ECMO patients not receiving CRRT and an LD of 800 mg and an MD of 600 mg for those receiving CRRT. For severe infections, an optimal dose was an LD of 1,000 mg and an MD of 800 mg for ECMO patients not receiving CRRT and an LD of 1,200 mg and an MD of 1,000 mg for those receiving CRRT. In conclusion, doses higher than the standard doses are needed to achieve fast and appropriate teicoplanin exposure during ECMO. (This study has been registered at ClinicalTrials.gov under identifier NCT02581280.) |
| تدمد: | 1098-6596 0066-4804 0258-1280 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f9f52056205041e1eed0e9e9ba6fd2af https://doi.org/10.1128/aac.01015-17 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....f9f52056205041e1eed0e9e9ba6fd2af |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 10986596 00664804 02581280 |
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