Pharmacodynamic profiling of optimal sulbactam regimens against carbapenem-resistant Acinetobacter baumannii for critically ill patients
Objective: To study the minimum inhibitory concentration (MIC) of sulbactam against carbapenem-resistant Acinetobacter baumannii (CR-AB) and to determine the dosage regimens reaching target time of free drug concentration remaining above the MIC (fT>MIC). Methods: Clinical isolates of CR-AB from...
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Wolters Kluwer Medknow Publications
2018
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ftdoajarticles:oai:doaj.org/article:80e28f0ee15947b797b296d9f0099055 2023-05-15T15:12:32+02:00 Pharmacodynamic profiling of optimal sulbactam regimens against carbapenem-resistant Acinetobacter baumannii for critically ill patients Weerayuth Saelim Wichai Santimaleeworagun Sudaluck Thunyaharn Dhitiwat Changpradub Piraporn Juntanawiwat 2018-01-01T00:00:00Z https://doi.org/10.4103/2221-1691.221129 https://doaj.org/article/80e28f0ee15947b797b296d9f0099055 EN eng Wolters Kluwer Medknow Publications http://www.apjtb.org/article.asp?issn=2221-1691;year=2018;volume=8;issue=1;spage=14;epage=18;aulast=Saelim https://doaj.org/toc/2221-1691 2221-1691 doi:10.4103/2221-1691.221129 https://doaj.org/article/80e28f0ee15947b797b296d9f0099055 Asian Pacific Journal of Tropical Biomedicine, Vol 8, Iss 1, Pp 14-18 (2018) acinetobacter baumannii critically ill patients monte carlo simulation mic Arctic medicine. Tropical medicine RC955-962 Biology (General) QH301-705.5 article 2018 ftdoajarticles https://doi.org/10.4103/2221-1691.221129 2022-12-31T13:47:32Z Objective: To study the minimum inhibitory concentration (MIC) of sulbactam against carbapenem-resistant Acinetobacter baumannii (CR-AB) and to determine the dosage regimens reaching target time of free drug concentration remaining above the MIC (fT>MIC). Methods: Clinical isolates of CR-AB from patients admitted to Phramongkutklao Hospital, Thailand from January 2014 to December 2015 were obtained. The MIC of sulbactam for each CR-AB isolate was determined using the agar dilution method. Each sulbactam regimen was simulated using the Monte Carlo technique to calculate the probability of target attainment (PTA) and the cumulative fraction of response (CFR) in critically ill patients. PTA was defined by how likely a specific drug dose was to reach 40% and 60% fT>MIC. The CFR was the probability of drug dose covering the MIC range of CR-AB. Dosing regimens reaching above 80% of PTA and CFR, were considered as the optimal dosage for documented and empirical therapy, respectively. Results: A total of 118 CR-AB isolates were included in the study. The percentile at the fiftieth and ninetieth MIC of sulbactam were 64 and 192 μg/mL, respectively. For a MIC of sulbactam of 4 μg/mL, all dosage regimens achieved PTA target. However, only a sulbactam dosage of 12 g intravenous daily using 2-4 h infusion or continuous infusion that covered for isolates with a sulbactam MIC of 96 μg/mL, met the PTA or CFR targets. Conclusions: The MIC of sulbactam against CR-AB is quite high. The sulbactam dose of 12 g/day using prolonged infusion was required to achieve the target fT>MIC for CR-AB treatment. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Asian Pacific Journal of Tropical Biomedicine 8 1 14 |
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English |
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acinetobacter baumannii critically ill patients monte carlo simulation mic Arctic medicine. Tropical medicine RC955-962 Biology (General) QH301-705.5 |
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acinetobacter baumannii critically ill patients monte carlo simulation mic Arctic medicine. Tropical medicine RC955-962 Biology (General) QH301-705.5 Weerayuth Saelim Wichai Santimaleeworagun Sudaluck Thunyaharn Dhitiwat Changpradub Piraporn Juntanawiwat Pharmacodynamic profiling of optimal sulbactam regimens against carbapenem-resistant Acinetobacter baumannii for critically ill patients |
topic_facet |
acinetobacter baumannii critically ill patients monte carlo simulation mic Arctic medicine. Tropical medicine RC955-962 Biology (General) QH301-705.5 |
description |
Objective: To study the minimum inhibitory concentration (MIC) of sulbactam against carbapenem-resistant Acinetobacter baumannii (CR-AB) and to determine the dosage regimens reaching target time of free drug concentration remaining above the MIC (fT>MIC). Methods: Clinical isolates of CR-AB from patients admitted to Phramongkutklao Hospital, Thailand from January 2014 to December 2015 were obtained. The MIC of sulbactam for each CR-AB isolate was determined using the agar dilution method. Each sulbactam regimen was simulated using the Monte Carlo technique to calculate the probability of target attainment (PTA) and the cumulative fraction of response (CFR) in critically ill patients. PTA was defined by how likely a specific drug dose was to reach 40% and 60% fT>MIC. The CFR was the probability of drug dose covering the MIC range of CR-AB. Dosing regimens reaching above 80% of PTA and CFR, were considered as the optimal dosage for documented and empirical therapy, respectively. Results: A total of 118 CR-AB isolates were included in the study. The percentile at the fiftieth and ninetieth MIC of sulbactam were 64 and 192 μg/mL, respectively. For a MIC of sulbactam of 4 μg/mL, all dosage regimens achieved PTA target. However, only a sulbactam dosage of 12 g intravenous daily using 2-4 h infusion or continuous infusion that covered for isolates with a sulbactam MIC of 96 μg/mL, met the PTA or CFR targets. Conclusions: The MIC of sulbactam against CR-AB is quite high. The sulbactam dose of 12 g/day using prolonged infusion was required to achieve the target fT>MIC for CR-AB treatment. |
format |
Article in Journal/Newspaper |
author |
Weerayuth Saelim Wichai Santimaleeworagun Sudaluck Thunyaharn Dhitiwat Changpradub Piraporn Juntanawiwat |
author_facet |
Weerayuth Saelim Wichai Santimaleeworagun Sudaluck Thunyaharn Dhitiwat Changpradub Piraporn Juntanawiwat |
author_sort |
Weerayuth Saelim |
title |
Pharmacodynamic profiling of optimal sulbactam regimens against carbapenem-resistant Acinetobacter baumannii for critically ill patients |
title_short |
Pharmacodynamic profiling of optimal sulbactam regimens against carbapenem-resistant Acinetobacter baumannii for critically ill patients |
title_full |
Pharmacodynamic profiling of optimal sulbactam regimens against carbapenem-resistant Acinetobacter baumannii for critically ill patients |
title_fullStr |
Pharmacodynamic profiling of optimal sulbactam regimens against carbapenem-resistant Acinetobacter baumannii for critically ill patients |
title_full_unstemmed |
Pharmacodynamic profiling of optimal sulbactam regimens against carbapenem-resistant Acinetobacter baumannii for critically ill patients |
title_sort |
pharmacodynamic profiling of optimal sulbactam regimens against carbapenem-resistant acinetobacter baumannii for critically ill patients |
publisher |
Wolters Kluwer Medknow Publications |
publishDate |
2018 |
url |
https://doi.org/10.4103/2221-1691.221129 https://doaj.org/article/80e28f0ee15947b797b296d9f0099055 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Asian Pacific Journal of Tropical Biomedicine, Vol 8, Iss 1, Pp 14-18 (2018) |
op_relation |
http://www.apjtb.org/article.asp?issn=2221-1691;year=2018;volume=8;issue=1;spage=14;epage=18;aulast=Saelim https://doaj.org/toc/2221-1691 2221-1691 doi:10.4103/2221-1691.221129 https://doaj.org/article/80e28f0ee15947b797b296d9f0099055 |
op_doi |
https://doi.org/10.4103/2221-1691.221129 |
container_title |
Asian Pacific Journal of Tropical Biomedicine |
container_volume |
8 |
container_issue |
1 |
container_start_page |
14 |
_version_ |
1766343209514958848 |