Optimization the dosing regimens of fosfomycin by Monte Carlo simulation
10.13699/j.cnki.1001-6821.2014.09.018
- VernacularTitle:蒙特卡洛模拟优化磷霉素的给药方案
- Author:
Jing-Chao ZHOU
1
;
Sui-Yang ZHANG
;
Ding-Hua ZHOU
;
Wei-Hang TONG
;
Xiao-Hua CHI
;
Dan WANG
Author Information
1. 中国人民解放军第二炮兵总医院
- Keywords:
fosfomycin;
prolonged infusion therapy;
optimized two -step infusion therapy;
Monte Carlo simulation;
probability of target at-tainment
- From:
The Chinese Journal of Clinical Pharmacology
2014;(9):810-812
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the pharmadynamics of fosfomycin in different dosing regimens to obtain the optimal clinical dosing regimen by Monte carlo simulation.Methods Pharmacokinetic datas of fosfomycin in lung tissue of septic patients were determined by in vivo microdialysis , application software ( Crystal Ball 7.2.2 ) performed Monte Carlo simula-tion of 10 000 patients to calculate the probability of target attainment ( PTA) of different doseing regimens.And combined with maximum drug concentration/minimum inhibitory concentration ( cmax/MIC).Results Of all the dosing regimens , PTA(6 g/q6 h) is best, however, when MIC>20, the PTA<50%.The probability of cmax/MIC≥4:prolonged infu-sion therapy ( PIT) (6 g/q6 h)>PIT(4 g/q6 h)>optimized two-step infusion therapy (OTIT) (6 g/q6 h)>OTIT(4 g/q6 h).When MIC≤16 , the antimicrobial PTA is approximately 100%,while the bactericidal PTA reduces to 66.48%.Conclusion When MIC≤20 , the prolonged infusion therapy of 6 g/6 h is best; while MIC>20 , PTA<50%, with poor clinical results , the best choice was drug combination.
