Comparison of probability of target attainment calculated by Monte Carlo simulation with meropenem clinical and microbiological response for the treatment of complicated skin and skin structure infections

Simultaneous determination of three carbapenem antibiotics in plasma by HPLC with ultraviolet detection

“…This result was consistent with the study of DeRyke et al who found that, for the same bacteria and equivalent doses, around 15-30% of the patients do not achieve the optimal efficacy with imipenem or meropenem [9]. Similarly, Kuti et al showed that for MICs of 2 and 4 mg/L, only 60 and 15% of the patients, respectively attained the pharmacodynamic endpoint during skin infections with the recommended 0.5 g three times a day meropenem dose [10]. All these results strongly suggest the need for an individualized dose adjustment depending on the site of infection, the causative bacteria, and the corresponding MIC.…”

Optimal treatment schedule of meropenem for adult patients with febrile neutropenia based on pharmacokinetic–pharmacodynamic analysis

“…Therefore, meropenem is commonly used in empiric therapies for infectious diseases. A number of pharmacokinetic (PK)-pharmacodynamic (PD) simulations (so-called Monte Carlo simulations) for meropenem have been reported, and such simulations are considered to be an important approach for the prediction of antibacterial efficacy of meropenem [1][2][3][4][5][6][7][8][9][10]. For PK simulation, some reports used a simple compartment model that did not describe covariates for PK variability or individual variability [1,2,6,7,9].…”

“…For an important PD index for meropenem, all the previous studies considered the percent time above minimum inhibitory concentration (%T [ MIC). Levels of 20-30%T [ MIC were proposed to achieve bacteriostatic effects and 40-50%T [ MIC was proposed to achieve bactericidal outcomes [1][2][3][4][5][6][7][8][9][10]. Some reports estimated target attainment rates of bacteriostatic exposures (target, 30%T [ MIC) and/or bactericidal exposures (target, 50%T [ MIC) after various dosage regimens against bacteria for various MICs [1,7,10].…”

Optimising antibiotic dosing regimens based on pharmacodynamic target attainment against Pseudomonas aeruginosa collected in Hungarian hospitals

“…The use of Monte Carlo simulation, which incorporates variability in pharmacokinetic parameters and local MIC distributions, has been proposed to evaluate the probability of target attainment for antimicrobials against various bacterial pathogens [12,13] and provides a reasonable prediction of clinical and microbiological outcomes in patients [14]. This methodology is utilised in the Optimizing Pharmacodynamic Target Attainment using the MYSTIC Antibiogram (OPTAMA) Program to estimate the likelihood of specific antibiotic dosing regimens attaining targeted pharmacodynamic exposures against pathogens of interest across various regions of the world [15][16][17].…”