| Title: | Optimizing fosfomycin dosing regimens in critically ill patients with and without continuous renal replacement therapy |
| Researcher: | Taniya Charoensareerat, Phongphak Bunrit, Sasina Phanpoka, Thananya Netthanomsak, Dhakrit Rungkitwattanakul, Sutthiporn Pattharachayakul, Nattachai Srisawat, Weerachai Chaijamorn |
| Degree: | Doctor of Pharmacy Program in Pharmaceutical Care |
| Major: | Pharm.D. (Pharm.Care) |
| Faculty of study: | Pharmacy |
| Academic year: | 2567 (2024) |
| Published: | Journal of Critical Care, Volume 85, February 2025, 154946, Pages 1-7. doi: https://doi.org/10.1016/j.jcrc.2024.154946 Click |
Abstract
Purpose: To defne the optimal fosfomycin dosing regimens for drug-resistant gram-negative bacteria in critically ill patients and those receiving continuous renal replacement therapy (CRRT) via Monte Carlo simulations.
Materials and methods: A pharmacokinetic model for patients with and without CRRT was created to predict fosfomycin deposition in these patients. The pharmacodynamics (PD) targets were AUC/MIC ratio ω 21.5, 28.2, and 98.8 for drug-resistant Klebsiella pneumoniae (KP), Pseudomonas aeruginosa (PA) and Escherichia coli (EC) infections, respectively. The optimal regimen was defned when the probability of target attainment (PTA) was ω90 % of the virtual patients.
Results: The fosfomycin dosing regimens for KP infections with MIC 64 mg/L in critically ill patients and who received CRRT were 6 g every 8 h and 8 g every 12 h, respectively. For PA infections, the regimens of 6 g every 6 h and 7 g every 8 h achieved the target in critically ill patients and those undergoing CRRT. No regimen achieved the 90 % PTA against the EC infection with MIC ω32 mg/L.
Conclusions: Dosing regimens for bacteria with high MICs as 64 mg/L in these patients were 18–24 g/day. Dose adjustments were required in those undergoing CRRT. Clinical validation is strongly needed.
Keywords: Fosfomycin, Critically ill, Continuous renal replacement therapy, Pharmacokinetics, Monte Carlo simulation
Optimizing fosfomycin dosing regimens in critically ill patients with and without continuous renal replacement therapy. 2567 (2024). -. บทความ (Paper). Advisor: ดร. ธนิยา เจริญเสรีรัตน์ – Dr. Taniya Charoensareerat. วิทยาศาสตร์สุขภาพ|Health Science. เภสัชศาสตร์ (Pharmacy). เภสัชศาสตรบัณฑิต ภ.บ. (การบริบาลทางเภสัชกรรม) – Pharm.D. (Pharm.Care). หลักสูตรเภสัชศาสตรบัณฑิต สาขาวิชาการบริบาลทางเภสัชกรรม – Doctor of Pharmacy Program in Pharmaceutical Care. Bangkok: Siam University
Academic Year 2023, วิทยาศาสตร์สุขภาพ|Health Science, เภสัชศาสตร์ (Pharmacy), เภสัชศาสตรบัณฑิต ภ.บ. (การบริบาลทางเภสัชกรรม) – Pharm.D. (Pharm.Care),หลักสูตรเภสัชศาสตรบัณฑิต สาขาวิชาการบริบาลทางเภสัชกรรม – Doctor of Pharmacy Program in Pharmaceutical Care