Evaluation of once daily tobramycin dosing in critically ill patients through Bayesian simulation.

Abstract:

OBJECTIVE:To evaluate if once-daily dose (ODD) regimens of tobramycin attain pharmacodynamic goals using individualized pharmacokinetic monitoring of critically ill patients with creatinine clearance (Clcr) over 60 mL/min. METHODS:Fifty-one adult critically ill patients treated with intravenous tobramycin with ODD were included in the study. The effect of dosing using the proposed method was compared with a weight-based (7 mg/kg) dosing method. Pharmacokinetics parameters, peak concentration (Cpeak), minimum concentration (Cmin) and the time below the minimum inhibitory concentration (MIC) were estimated using Bayesian analysis. Pharmacodynamic parameters used to evaluate both dosing regimens were Cpeak/MIC ratio and, secondly, time below MIC (T< MIC). RESULTS:The median dose of tobramycin administrated in our hospital was too low for achieving pharmacodynamic goals. In contrast, the weight-based (7 mg/kg) method produced an adequate Cpeak/MIC ratio but an increase of the dose would not reduce the secondary pharmacodynamic index T60 mL/min achieved the Cpeak/MIC target values of 10. However in critically ill patients with Clcr>80 mL/min, T

journal_name

J Clin Pharm Ther

authors

Peris-Marti JF,Borras-Blasco J,Rosique-Robles JD,Gonzalez-Delgado M

doi

10.1111/j.1365-2710.2003.00539.x

subject

Has Abstract

pub_date

2004-02-01 00:00:00

pages

65-70

issue

1

eissn

0269-4727

issn

1365-2710

pii

539

journal_volume

29

pub_type

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