Limited-sampling strategies for anidulafungin in critically ill patients
| Autor: | Donald R. A. Uges, Marjolijn J. P. van Wanrooy, Michael G. G. Rodgers, Jos G. W. Kosterink, Tjip S. van der Werf, Johannes H. Proost, Jan G. Zijlstra, Jan-Willem C. Alffenaar |
|---|---|
| Přispěvatelé: | Nanomedicine & Drug Targeting, Biopharmaceuticals, Discovery, Design and Delivery (BDDD), Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE) |
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Bayes theorem
loading drug dose NCT01047267 Bayes' theorem Echinocandins Statistics Pharmacology (medical) Prospective Studies population model drug monitoring education.field_of_study clinical article medicine.diagnostic_test adult Area under the curve article Middle Aged invasive candidiasis aged Infectious Diseases female priority journal blood sampling pharmacokinetics medicine.drug drug dose increase medicine.medical_specialty drug exposure area under the curve Critical Illness Population Clinical Therapeutics minimum inhibitory concentration anidulafungin drug clearance Young Adult critically ill patient Pharmacokinetics male Linear regression medicine Humans Candidiasis Invasive controlled study human Intensive care medicine education Pharmacology controlled clinical trial business.industry maximum plasma concentration prediction compartment model minimum plasma concentration Therapeutic drug monitoring drug blood level linear regression analysis Anidulafungin business plasma concentration-time curve Blood sampling |
| Zdroj: | Antimicrobial Agents and Chemotherapy, 59(2), 1177-1181. AMER SOC MICROBIOLOGY |
| ISSN: | 1098-6596 |
| Popis: | Efficacy of anidulafungin is driven by the area under the concentration-time curve (AUC)/MIC ratio. Determination of the anidulafungin AUC along with MIC values can therefore be useful. Since obtaining a full concentration-time curve to determine an AUC is not always feasible or appropriate, limited-sampling strategies may be useful in adequately estimating exposure. The objective of this study was to develop a model to predict the individual anidulafungin exposure in critically ill patients using limited-sampling strategies. Pharmacokinetic data were derived from 20 critically ill patients with invasive candidiasis treated with anidulafungin. These data were used to develop a two-compartment model in MW\Pharm using an iterative 2-stage Bayesian procedure. Limited-sampling strategies were subsequently investigated using two methods, a Bayesian analysis and a linear regression analysis. The best possible strategies for these two methods were evaluated by a Bland-Altman analysis for correlation of the predicted and observed AUC from 0 to 24 h (AUC 0–24 ) values. Anidulafungin exposure can be adequately estimated with the concentration from a single sample drawn 12 h after the start of the infusion either by linear regression ( R 2 = 0.99; bias, 0.05%; root mean square error [RMSE], 3%) or using a population pharmacokinetic model ( R 2 = 0.89; bias, −0.1%; RMSE, 9%) in critically ill patients and also in less severely ill patients, as reflected by healthy volunteers. Limited sampling can be advantageous for future studies evaluating the pharmacokinetics and pharmacodynamics of anidulafungin and for therapeutic drug monitoring in selected patients. (This study has been registered at ClinicalTrials.gov under registration no. NCT01047267.) |
| Databáze: | OpenAIRE |
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