Optimization of sulbactam regimens in intensive care unit continuous veno-venous hemofiltration patients with Monte Carlo simulation method
AIM To optimize sulbactam regimens for intensive care unit(ICU)continuous veno-venous hemofiltration(CVVH)patients using the Monte Carlo simulation method.METHODS Pharmacokinetic/pharmacodynamic(PK/PD)parameters of sulbactam in ICU CVVH patients and the minimum inhibitory concentration(MIC)of Acinetobacter baumannii(AB)were collected.Monte Carlo simulations(n=5 000)were conducted to assess the rationality of the dosing regimen.The PK/PD target values for AB were 40％fT＞MIC and 60％fT＞MIC.RESULTS For ICU patients with CVVH caused by AB,when the MIC was 4 mg·L-1,the recommended dosing regimens were traditional intravenous infusions of 1 g,q8h and 1 g,q6h(with each dose infused over 0.5 h).The empiric dosing regimens recommended under 2 PK/PD target values were 24-hour continuous intravenous infusion of 9 g,q24h and 12 g,q24h.CONCLUSION It is recommended to use either a 3-hour extended intravenous infusion or a 24-hour continuous intravenous infusion regimen for the treatment of AB strains with lower susceptibility.
pharmacokinetic/pharmacodynamicsulbactamMonte Carlo methodcontinuous venovenous hemofiltrationAcinetobacter baumannii
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