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

Ludwig, Endre; Konkoly-Thege, Marianne; Kuti, Joseph L.; Nicolau, David P.

doi:10.1016/j.ijantimicag.2006.07.014

Cited by 21 publications

(20 citation statements)

References 25 publications

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“…A report from Hungary also demonstrated these findings. Furthermore, that study further analysed the effect of pharmacodynamically enhanced dosage regimens on several antibiotics [14]. The report demonstrated similar findings to this analysis in that a higher dose of meropenem, along with the prolonged 3-h infusion, provided the greatest CFR against P. aeruginosa isolates.…”

Section: Discussionsupporting

confidence: 61%

“…Unfortunately, inadequate pharmacokinetic data for these antibiotics in healthy Chinese volunteers precluded us from including these agents in the current study. Both cefepime and piperacillin/tazobactam have demonstrated mixed findings with respect to CFR against non-fermenting Gram-negatives in other OPTAMA studies; therefore, we cannot speculate as to the performance of these antibiotics in China [5,14].…”

Section: Discussionmentioning

confidence: 80%

“…This regimen has been shown to achieve a high likelihood of bactericidal exposure up to a MIC of 16 g/mL. The prolonged infusion dosage strategy has also been applied to other antibiotics such as cefepime and piperacillin/tazobactam with success [14,15]. Unfortunately, inadequate pharmacokinetic data for these antibiotics in healthy Chinese volunteers precluded us from including these agents in the current study.…”

Section: Discussionmentioning

confidence: 99%

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Pharmacodynamic target attainment of seven antimicrobials against Gram-negative bacteria collected from China in 2003 and 2004

Wang

et al. 2007

International Journal of Antimicrobial Agents

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

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Pharmacodynamic target attainment of seven antimicrobials against Gram-negative bacteria collected from China in 2003 and 2004

Wang

et al. 2007

International Journal of Antimicrobial Agents

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“…This pharmacodynamically optimized regimen for meropenem can achieve ≥ 40% fT>MIC against organism considered meropenem intermediate (MIC = 8 µg/ml) and those considered resistant (MIC = 16 µg/ml) (42,73). Similarly, a high dose prolonged infusion of cefepime (2g q8h as a 3-4 hour infusion) can achieve ≥ 50% fT>MIC against organisms considered cefepime intermediate (MIC = 16 µg/ml) and resistant (MIC = 32 mg/ml) (52,73). In the unfortunate case that organisms with these MIC values exist in one's hospital population, these optimized dosing regimens should be advocated empirically until susceptibility data are available.…”

Section: Optimizing Pharmacodynamicsmentioning

confidence: 99%

Employing pharmacokinetic and pharmacodynamic principles to optimize antimicrobial treatment in the face of emerging resistance

Filho¹,

Kuti²,

Nicolau³

2007

Braz. J. Microbiol.

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Antimicrobial efficacy in vivo is not exclusively defined by the activity of an antibiotic as determined in the in vitro susceptibility test. Knowledge of the pharmacokinetics and pharmacodynamics of antimicrobials and all phenomena occurring between antimicrobial agents and microorganisms is imperative. The pharmacodynamic (PD) parameters most often used in studies of antibiotic effect include the following relationships: the maximum free concentration (fCmax) to minimum inhibitory concentration (MIC) ratio, the free area under the curve (fAUC/MIC) ratio and the duration of time the free concentration exceeds the MIC (fT>MIC). Utilization of known pharmacokinetic/ pharmacodynamic surrogate relationships should help to optimize treatment outcome, especially in the face of emerging resistance among Gram-positive and Gramnegative bacteria. Clinical studies in the field of antibacterial PD are still relatively scarce, and much information is needed to enable relevant dosing strategies for all types of antibiotics against all common infections and microorganisms. In this review, the distinctive patterns of antimicrobial activity based on PD parameters are discussed. Various antibiotics and bacterial pathogens can be used as models to demonstrate the utility of PD parameters in predicting the in vivo efficacy of antimicrobial therapy. And finally, the use of computer modeling with Monte Carlo population simulations can further enhance the predictability of antimicrobial efficacy when using PD parameters.

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“…18 For carbapenems, near maximal cell killing occurs at 40% of the dosing interval. [19][20][21][22][23][24][25][26] Among the strategies for achieving this goal is extending the time over which the infusion occurs. 15 This requires that a carbapenem remain stable from the time it is prepared for infusion until the end of the infusion period.…”

Section: Is (4r 5s 6s)-3-[((3s5s)-5-[[(amino Sulfonyl)amino] Methymentioning

confidence: 99%

A Review of Doripenem for the Treatment of Serious Bacterial Infections

Redman

Flamm²,

Cirillo³

2010

Clinical Medicine Reviews in Therapeutics

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Doripenem is a carbapenem bactericidal agent that demonstrates in vitro activity against a wide variety of Gram-negative and Gram-positive pathogens. In vitro data show that doripenem combines the intrinsic activity of meropenem against Gram-negative pathogens with the intrinsic activity of imipenem against Gram-positive pathogens. The availability of doripenem is particularly welcome in the current setting of increased resistance among Gram-negative pathogens including Pseudomonas aeruginosa, Acinetobacter species, and extended-spectrum β-lactamase-producing Enterobacteriaceae. Characteristic of doripenem is its potent activity against P. aeruginosa with a minimum inhibitory concentration (MIC) necessary for the inhibition of 90% of all isolates (MIC 90 ) of 4 µg/mL, a value that is 2 to 4 times lower than the corresponding MIC 90 values of meropenem and imipenem. Doripenem was shown to be noninferior to other commonly used antibiotics in phase 3 clinical trials and is currently approved for the treatment of complicated intra-abdominal infection and complicated urinary tract infection, and in some countries for the treatment of nosocomial pneumonia, including ventilator-associated pneumonia. Intravenous (IV) infusions of doripenem can be either 1 hour or for longer durations of 4 hours. Overall, IV doripenem is safe and well tolerated, with a limited propensity to induce seizures compared with other carbapenems. Doripenem may represent a valuable option when carbapenem therapy is warranted for the treatment of serious infection, particularly in cases in which the etiology is a drug-resistant, Gram-negative pathogen.

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

Cited by 21 publications

References 25 publications

Pharmacodynamic target attainment of seven antimicrobials against Gram-negative bacteria collected from China in 2003 and 2004

Pharmacodynamic target attainment of seven antimicrobials against Gram-negative bacteria collected from China in 2003 and 2004

Employing pharmacokinetic and pharmacodynamic principles to optimize antimicrobial treatment in the face of emerging resistance

A Review of Doripenem for the Treatment of Serious Bacterial Infections

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