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Pharmacokinetic/pharmacodynamic modeling and simulation to determine effective dosage regimens for doripenem

✍ Scribed by Katsube, Takayuki (author);Yano, Yoshitaka (author);Wajima, Toshihiro (author);Yamano, Yoshinori (author);Takano, Mikihisa (author)


Publisher
John Wiley and Sons Inc.
Year
2010
Tongue
English
Weight
170 KB
Volume
99
Category
Article
ISSN
0022-3549

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✦ Synopsis


The aim of this study was to obtain information on effective dosage regimens of doripenem by a modeling and simulation approach based on pharmacokinetic (PK)/pharmacodynamic (PD) theory. The PK/PD model we have already developed was modified to explain in vitro bactericidal kinetics of doripenem for several Pseudomonas aeruginosa strains. Time-course profiles of bacterial counts in patients infected with P. aeruginosa were simulated for typical clinical dosage regimens in Japan considering the variability of PK and the patients' backgrounds by a Monte Carlo simulation. Moreover, time-course profiles of probability achieving the criterion (log(CFU/mL) < 0) were predicted for the evaluation of antibacterial efficacy by renal function. The in vitro bacterial profiles at various dosage regimens could be well explained by the PK/PD model. The simulations suggested the dependence of antibacterial efficacy on the frequency of administration, indicating time-dependent antibacterial activity. It was also suggested that 500 mg t.i.d. showed significant bacterial reduction in patients for any degree of renal function and any severities in 2 weeks after the start of treatment. Our approach to simulate time-course profiles of bacterial counts should be useful for determining and examining effective dosage regimens, including the treatment period, in drug development.


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