Peritoneal dialysis-associated peritonitis (PDAP) can be treated using very different regimens of antimicrobial administration, regimens that result in different pharmacokinetic outcomes and systemic exposure levels. Currently, there is no population-level pharmacokinetic framework germane to the treatment of PDAP. We coupled a differential-equation-based model of antimicrobial kinetics to a Monte Carlo simulation framework, and conducted "in silico" clinical trials to explore the anticipated effects of different antimicrobial dosing regimens on relevant pharmacokinetic parameters (AUC/MIC and time greater than 5 ×MIC) and the level of systemic exposure.
The optimal duration of expiratory TGI flow application is stable over a wide range of impedance characteristics. Such stability suggests that near maximal effect of expiratory TGI could be obtained by applying TGI flow solely within the final 50% of the expiratory phase. Such uniform restriction of the application profile might both simplify technique implementation and decrease adverse consequences.
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