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This study showed that optimal voriconazole dosage regimens could be determined successfully with prospective population pharmacokinetic analyses and Monte Carlo simulations.

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This study was performed to evaluate the prevalence of erectile dysfunction (ED) and to explore its correlation to chronic prostatitis in China. A cross-sectional investigation from a large cohort study of Chinese men was used in this survey. A questionnaire consisting of general information regarding socio-demographics, chronic disease history, sexual function, the National Institutes of Health-Chronic Prostatitis Symptom Index, and the International Index of Erectile Function-5 (IIEF-5) was administered to 15 000 Chinese men aged from 15 to 60. The prevalence of ED was determined from the patient's self-evaluation and IIEF-5 score. The eligible individual both was married and had intercourse experience. In total, there were 12 743 respondents, giving a response rate of 84.95%. Among 7372 eligible men, ED prevalence as assessed by self-report and IIEF-5 score was 12.0% and 17.1%, respectively. Among 771 men with prostatitis-like symptoms, ED prevalence as assessed by self-report and IIEF-5 score was 39.3% and 30.1%, respectively. Among 370 men suffering from chronic prostatitis, ED prevalence as assessed by self-report and IIEF-5 score was 40.5% and 35.1%, respectively. The prevalence of self-reported and IIEF-5 score-assessed ED had high correlation with increasing age among all eligible men, men with prostatitis-like symptoms, and men with chronic prostatitis (P t , .05, P s , .05, P cp , .05). ED prevalence as assessed by both self-report and IIEF-5 score was higher in men with prostatitis-like symptoms and with chronic prostatitis than in the general group (P s , .05, P cp , .05). The prevalence of ED was higher in the prostatitis population than in the general population with either self-reported or IIEF-5 score assessment. The prevalence was higher with self-reported than with IIEF-5 assessment in men with prostatitis. Estimates of ED prevalence among men with prostatitis should not rely on self-reporting alone in that this is likely to overestimate the true prevalence.

We sought to describe the population pharmacokinetics of tigecycline in critically ill patients and to determine optimized dosing regimens of tigecycline for different bacterial infections. This prospective study included 10 critically ill patients given a standard dose of tigecycline. Blood samples were collected during one dosing interval and were analyzed using validated chromatography. Population pharmacokinetics and Monte Carlo dosing simulations were undertaken using Pmetrics. Three target exposures, expressed as ratios of the 24-h area under the curve to MICs (AUC 0 -24 /MIC), were evaluated (Ն17.9 for skin infections, Ն6.96 for intraabdominal infections, Ն4.5 for hospital-acquired pneumonia). The median age, total body weight, and body mass index (BMI) were 67 years, 69.1 kg, and 24.7 kg/m 2 , respectively. A two-compartment linear model best described the time course of tigecycline concentrations. The parameter estimates (expressed as means Ϯ standard deviations [SD]) from the final model were as follows: clearance (CL), 7.50 Ϯ 1.11 liters/h; volume in the central compartment, 72.50 Ϯ 21.18 liters; rate constant for tigecycline distribution from the central to the peripheral compartment, 0.31 Ϯ 0.16 h Ϫ1 ; and rate constant for tigecycline distribution from the peripheral to the central compartment, 0.29 Ϯ 0.30 h Ϫ1 . A larger BMI was associated with increased CL of tigecycline. Licensed doses were found to be sufficient for Enterobacter cloacae, Escherichia coli, Klebsiella pneumoniae, and methicillin-resistant Staphylococcus aureus for an AUC 0 -24 /MIC target of 4.5 or 6.96. For a therapeutic target of 17.9, an increased tigecycline dose is required, especially for patients with higher BMI. The dosing requirements of tigecycline differ with the indication, with pathogen susceptibility, and potentially with patient BMI.

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