Development of Population and Bayesian Models for Applied Use in Patients Receiving Cefepime.

Abstract:

BACKGROUND AND OBJECTIVE:Understanding pharmacokinetic disposition of cefepime, a β-lactam antibiotic, is crucial for developing regimens to achieve optimal exposure and improved clinical outcomes. This study sought to develop and evaluate a unified population pharmacokinetic model in both pediatric and adult patients receiving cefepime treatment. METHODS:Multiple physiologically relevant models were fit to pediatric and adult subject data. To evaluate the final model performance, a withheld group of 12 pediatric patients and two separate adult populations were assessed. RESULTS:Seventy subjects with a total of 604 cefepime concentrations were included in this study. All adults (n = 34) on average weighed 82.7 kg and displayed a mean creatinine clearance of 106.7 mL/min. All pediatric subjects (n = 36) had mean weight and creatinine clearance of 16.0 kg and 195.6 mL/min, respectively. A covariate-adjusted two-compartment model described the observed concentrations well (population model R2, 87.0%; Bayesian model R2, 96.5%). In the evaluation subsets, the model performed similarly well (population R2, 84.0%; Bayesian R2, 90.2%). CONCLUSION:The identified model serves well for population dosing and as a Bayesian prior for precision dosing.

journal_name

Clin Pharmacokinet

authors

Liu J,Neely M,Lipman J,Sime F,Roberts JA,Kiel PJ,Avedissian SN,Rhodes NJ,Scheetz MH

doi

10.1007/s40262-020-00873-3

subject

Has Abstract

pub_date

2020-08-01 00:00:00

pages

1027-1036

issue

8

eissn

0312-5963

issn

1179-1926

pii

10.1007/s40262-020-00873-3

journal_volume

59

pub_type

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