Pharmacokinetics/pharmacodynamics(PK/PD)of meropenem during continuous renal replacement therapy in a septic rabbits model based on microdialysis technology
10.3867/j.issn.1000-3002.2025.03.005
- VernacularTitle:基于微透析技术的连续性肾脏替代治疗脓毒症兔模型美罗培南药代动力学/药效学研究
- Author:
Ying SHAO
1
;
Dan WANG
Author Information
1. 河北燕达医院药物临床试验机构,河北廊坊 065201
- Publication Type:Journal Article
- Keywords:
meropenem;
sepsis;
microdialysis;
pharmacokinetic/pharmacodynamic;
monte carlo simulation
- From:
Chinese Journal of Pharmacology and Toxicology
2025;39(3):199-207
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To study the pharmacokinetics/pharmacodynamics(PK/PD)profiles of meropenem in the plasma,lung,muscle and skin tissues of rabbits,and to explore the effects of sepsis and continuous renal replacement therapy(CRRT)on the probability of target attainment(PTA)of meropenem.METHODS Twenty-four New Zealand rabbits were randomly divided into four equal groups:sepsis-CRRT group,sepsis group,normal-CRRT group and normal control group.Six hours after a rabbit model of sepsis was established via cecal ligation and puncture(CLP)surgery,an auto-matic infusion pump with meropenem[(1 000/60)×3.27=54.5 mg·kg-1,converted from that of humans(1g)to that of rabbits]was used to administer the drug to the animals for 0.5 h,while CRRT was started simultaneously with drug administration in the CRRT group.Microdialysis samples were collected from 4 target sites of each group once every 30 min for 480 min.The concentration of meropenem was deter-mined using liquid chromatography-tandem mass spectrometry(LC-MS/MS)before a concentration-time curve was constructed.Pharmacokinetic parameters such as the peak concentration(Cmax),time to reach peak concentration(Tmax),area under the concentration-time curve(AUC),and elimination half-life(t1/2)were calculated using a non-atrioventricular model.Monte Carlo simulation(MCS)was performed at various minimum inhibitory concentrations(MICs)using pharmacokinetic parameters of meropenem to assess the probability of target attainment(PTA).The predefined PK/PD target was％fT＞4MIC＞40％,where the percentage of time that the free drug concentration[f]exceeded 4 times that of the MIC during a dosing interval was above 40％and Cmax/MIC exceeded 4.RESULTS The results indicated no statistically significant differences between the PK parameters of skin tissue in the normal control group and sepsis group,whereas Cmax of other tissues was significantly lower in the sepsis group than in the normal control group(P＜0.01).AUCplasma and AUCskin were significantly increased(P＜0.01),while AUCIung and AUCmuscle were significantly decreased(P＜0.01)when the sepsis-CRRT group was compared with the sepsis group.With a target value of％fT＞4MIC＞40％,the plasma and skin tissues of the sepsis-CRRT group,the muscle tissues of the normal-CRRT group and the lung,muscle and skin tissues of the normal control group achieved a PTA of over 90％(MIC=1 mg·L-1).The skin tissues of the sepsis-CRRT group and the lung tissues of the normal control group achieved an efficacy target of more than 90％(MIC=2 mg·L-1).However,our results did not indicate that either AUC or Cmax was involved in the changes of PTA in the normal control group.For all tissues except skin tissues(MIC=4 mg·L-1),PTA decreased with Cmax in the sepsis group.The PTA of plasma and skin tissues increased with the AUC,while the PTA of lung(MIC=2,4 mg·L-1)and muscle tissues(MIC=1,2,4 mg·L-1)decreased with the AUC in the sepsis-CRRT group.CONCLUSION Sepsis has little effect on the distri-bution of meropenem in skin tissues.Sepsis may reduce the efficacy of meropenem in various tissues,and CRRT can improve the efficacy of plasma and skin tissues in sepsis.This method of collecting target samples with microdialysis probes is accurate and reliable,which can be used in therapeutic drug monitoring.
