Optimisation of fixed daily dose regimens for amikacin based on PPK auxiliary system of JPKD
AIM:To examine the predictive perfor-mance of the PPK software JPKD for the steady-state concentrations of amikacin and recommend the applicable conditions under fixed daily dosage of 400 mg and 600 mg.METHODS:Inpatients using amikacin in the First Affiliated Hospital of Bengbu Medical University from July 2022 to February 2024 were enrolled,and the measured concentra-tions of amikacin were detected by LC-MS/MS;Ver-ified the predictive performance of JPKD software for peak and trough concentrations of amikacin;JP-KD software was applied to predict the steady-state concentrations of amikacin in the patients at the infusion time of 0.5,1.0,1.5,2.0,2.5,and 3.0 h,and then compared the variability of steady-state concentrations with different levels of renal function at optimal infusion time,then the C max/MIC values were measured.RESULTS:A total of 69 patients were enrolled,including 18 patients with steady state trough concentrations and 17 patients with steady state peak concentrations.It was found that JPKD had a poor predictive ability for steady state trough concentrations but a good predictive ability for peak concentrations,the WRES＜10％be-tween predictive and measured concentrations,and a strong correlation existed between them(r=0.806).With the shortening infusion time,the high-er peak concentrations.The predicted peak concen-trations at 0.5 h and 1.0 h infusion time groups were(34.81±6.87)μg/mL and(32.51±6.07)μg/mL,respectively.With the decline of the renal function,the peak concentrations showed a increasing trend.On the same level of renal function,the peak concentrations in the 600 mg group was high-er than that of the 400 mg group.When MIC ≤2 μg/mL,400 mg daily dose was chosen;when MIC=4 μg/mL,400 mg daily dose could be used for CKD3b stage patients,and 600 mg daily dose could be used for CKD1,CKD2,and CKD3a stage patients;when MIC=8 μg/mL,it was predicted that a higher dose was needed to achieve the expected target.CONCLUSION:Amikacin is preferably administered intravenously for 0.5 to 1.0 h,fixed daily doses of 400 mg and 600 mg are indicated for some pa-tients according to the target bacterial MIC and re-nal function.
amikacinpopulation pharmacokinet-icJava PKfor Desktoprenal function
万方数据
维普
