Monte Carlo simulation improving therapeutic regimens of biapenem against enterobacteriaceae bacteria infection in elderly subjects
- Author:
Yong-Fu HANG
1
Author Information
- Publication Type:Journal Article
- Keywords: Biapeinan; Elderly population; MIC; Monte Carlo simulation
- From: Chinese Pharmaceutical Journal 2016;51(12):1028-1032
- CountryChina
- Language:Chinese
- Abstract: OBJECTIVE: To provide basis for rational use of biapenem in elderly patients through Monte Carlo simulation. METHODS: A total of 294 strains from five species of Enterobacteriaceae were collected. The MICs of biapenem against the bacteria were measured by double broth dilution method. Six therapeutic regimens (300 mg q24h; 300 mg q12h; 300 mg q8h; 300 mg q6h; 600 mg q24h; 600 mg q12h) were simulated by using Monte Carlo simulation, then the probability of target attainment (PTA) and cumulative fraction of response (CFR) were calculated. RESULTS: In patients at 65-74 years old, only the CFR of 300 mg q24h regimen was <90% (73.69%) for E. coli; only the CFRs of 300 mg and 600 mg q24h treatment regimens were <90% (64.98%,82.51%;63.83%,79.82%;63.11%,78.7%, respectively) for K. pneumonia, E. aerogenes and E. cloacae; in patients ≥75 years old, all of the regimens had PTAs >90% for E. coli and E. aerogenes; only the 300 mg q24h regimen had CFRs<90% (89.39% and 88.98%) for K. pneumonia and E. cloacae; for E. aerogenes, all the regimens had CFRs <90%. CONCLUSION: It is suggested that different regimens can be used for target therapy of biapenem on the basis of MICs, while frequency of q12h or higher can be used for experiential therapy of enterobacteriaceae infection in old people in our hospital. Other antimicrobial agents should be chosen for treatment of E. aerogenes.
