Pharmacokinetic/pharmacodynamic evaluation of tobramycin dosing in critically ill patients: the Hartford nomogram does not fit.

The Journal of Antimicrobial Chemotherapy
Feifan XieSanwang Li

Abstract

Extended-interval dosing of tobramycin is widely applied in patients with the Hartford nomogram as a representative, while this dosing approach has not been extensively evaluated in critically ill patients. The goal of this study was to characterize the pharmacokinetics of tobramycin and to evaluate the appropriateness of the Hartford nomogram in critically ill patients. A retrospective analysis was performed based on a medical critical care database. The extracted concentration data of tobramycin were used for the construction of the population pharmacokinetic model using a non-linear mixed-effects modelling approach. Real-world data-based simulations were conducted to evaluate the pharmacodynamic target attainment (Cmax/MIC ≥10) and safety (concentration <0.5 mg/L for at least 4 h) of the Hartford nomogram. A population pharmacokinetic model was built based on 307 measurements in 140 unique patients and externally validated by an independent study dataset. A two-compartment model was optimal for the structure model and creatinine clearance remained as the only covariate in the final model correlating to the clearance of tobramycin. Simulations indicated that the Hartford nomogram is effective for infections due to pathogens w...Continue Reading

References

Jan 1, 1976·Nephron·D W Cockcroft, M H Gault
Mar 1, 1991·Antimicrobial Agents and Chemotherapy·D N Gilbert
Sep 1, 1989·British Journal of Clinical Pharmacology·L AaronsF Follath
Oct 1, 1984·The American Journal of Medicine·R D MooreP S Lietman
Aug 1, 1981·Journal of Pharmacokinetics and Biopharmaceutics·L B Sheiner, S L Beal
Jun 1, 1995·Australian and New Zealand Journal of Medicine·M L BarclayR C Buttimore
Mar 1, 1995·Antimicrobial Agents and Chemotherapy·D P NicolauR Quintiliani
May 1, 1994·The Journal of Antimicrobial Chemotherapy·J A KarlowskyD J Hoban
Feb 10, 1996·BMJ : British Medical Journal·M BarzaJ Lau
Apr 29, 1998·Antimicrobial Agents and Chemotherapy·J G den HollanderJ W Mouton
Jul 24, 1998·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·M K LacyR Quintiliani
Aug 5, 2000·International Journal of Antimicrobial Agents·D XuanC H Nightingale
Jul 18, 2002·Intensive Care Medicine·S E BuijkH A Bruining
Jan 30, 2004·Journal of Clinical Pharmacy and Therapeutics·J F Peris-MartiM Gonzalez-Delgado
Jul 19, 2005·Computer Methods and Programs in Biomedicine·Lars LindbomNiclas Jonsson
Sep 20, 2005·International Journal of Antimicrobial Agents·Gabriel InclanJohn C Lukas
Dec 6, 2008·Therapeutic Drug Monitoring·Rhonda S ReaHoward Lee
Dec 15, 2010·British Journal of Clinical Pharmacology·Jean-Marie ConilSylvie Saivin
Feb 9, 2011·The AAPS Journal·Martin BergstrandMats O Karlsson
Feb 20, 2013·Clinical Pharmacokinetics·Stefanie HennigAlison H Thomson
Jul 10, 2013·CPT: Pharmacometrics & Systems Pharmacology·R J KeizerA Hooker
Jan 8, 2014·Journal of Pharmacokinetics and Pharmacodynamics·Catherine M T SherwinMichael G Spigarelli
May 25, 2016·Scientific Data·Alistair E W JohnsonRoger G Mark
Oct 13, 2016·Journal of Pharmacokinetics and Pharmacodynamics·Anne-Gaëlle DosneMats O Karlsson
Sep 20, 2017·CPT: Pharmacometrics & Systems Pharmacology·Holly Kimko, Kwan Lee

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