Antimicrobial efficacy of multiple Biapenem administration regimens based on pharmacokinetic/pharmacodynamic models for severe infectious diseases
Objective Based on pharmacokinetic/pharmacodynamic(PK/PD)models,Monte Carlo simulation was used to design a personalized medication regimen of Biapenem to improve the clinical effect in patients with severe infection.Meth-ods The pharmacokinetic parameters of Biapenem were collected from severe patients,and the target strains were Es-cherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa,Acinetobacter baumannii and Staphylococcus aureus,which were common pathogenic bacteria.The minimal inhibit concentration(MIC)value distribution of Biapenem against common bacteria was quoted in the bacterial drug resistance monitoring report in China.Different administration regimens were formulated by adjusting administration dose,administration interval and infusion time,and the probability of target at-tainment(PTA)and cumulative fraction of response(CFR)of different administration regimens of each target strain were cal-culated by Monte Carlo simulation to evaluate the antibacterial effect of each administration regimen in the treatment of se-vere infections.Results When MIC＜0.125 mg/L,PTA values of Biapenem were more than 90％in all administration regi-mens of 5 target strains.When MIC ≥4 mg/L,PTA values of all administration regimenes were＜90％.The CFR values of Biapenem for Escherichia coli were more than 90％,and for Acinetobacter baumannii,CFR values were less than 30％.Conclusion Biapenem can be used in the treatment of Escherichia coli by traditional administration.For the treatment of Klebsiella pneumoniae,600 mg q6 h delayed infusion for 3 h is the best treatment plan,or optimize the administration plan according to the MIC value.For Acinetobacter baumannii,pseudomonas aeruginosa and Staphylococcus aureus,re-placement or combination of other antibiotics should be considered to achieve efficacy.
BiapenemMonte Carlo simulationPharma-cokineticPharmacodynamicCritical patientAdministra-tion regimen
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