The use of Monte Carlo simulation to predict vancomycin dosage for methicillin-resistant Staphylococcus aureus in Thai patients of various ages and with varying degrees of renal function
| Autor: | Krairerk Pitaksontayothin, Panuwit Srisena, Wichai Santimaleeworagun, Manat Pongchaidecha, Jantana Houngsaitong |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty business.industry 030106 microbiology Geography Planning and Development Monte Carlo method Renal function Management Monitoring Policy and Law medicine.disease_cause Methicillin-resistant Staphylococcus aureus 03 medical and health sciences Internal medicine medicine Vancomycin business medicine.drug |
| Zdroj: | Asian Biomedicine. 11:379-386 |
| ISSN: | 1875-855X |
| Popis: | Background To our knowledge, no study reported so far has investigated appropriate vancomycin dosing, which is important for treatment of methicillin-resistant Staphylococcus aureus (MRSA) infection in Thai patients of various ages and with varying degrees of renal function. Objectives To predict vancomycin dosing for MRSA in Thai patients of various ages and with varying degrees of renal functions. Methods Monte Carlo simulation and minimal inhibitory concentration (MIC) distribution of MRSA from a hospital in Thailand were used to predict the area under the curve in 24 h/MIC >400 and trough concentration (C trough) Results Vancomycin dosing at least 2.5 g per day can attain cumulative fraction of response (CFR) of ≥90% in every age group. Vancomycin dosage achieving CFR of ≥90% for simulated patients with creatinine clearance (CLcr) was calculated using the Cockcroft–Gault equation. Appropriate vancomycin doses for Thai patients infected with MRSA with CLcr of 60–80, and >80 mL/min were 1.5 g every 24 h, 1.25 g every 12 h, 1 g every 8 h, and 1.75 g every 12 h, respectively. However, more than a half of patients simulated using these regimens have a vancomycin C trough of >20 mg/L. Conclusions Although vancomycin doses attaining a CFR of ≥90% can treat MRSA infection effectively, the regimens may cause kidney injury. The regimens have a probability of target attainment of 100%, and most patients can attain C trough of |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|