A dosing nomograph for cerebrospinal fluid penetration of meropenem applied by continuous infusion in patients with nosocomial ventriculitis

美罗培南 脑室炎 医学 加药 药代动力学 脑脊液 室外引流 肾功能 最小抑制浓度 内科学 药理学 麻醉 抗生素 微生物学 生物 抗生素耐药性
作者
Christina König,Jörn Grensemann,Patrick Czorlich,Eckhard Schlemm,Stefan Kluge,Sebastian G. Wicha
出处
期刊:Clinical Microbiology and Infection [Elsevier BV]
卷期号:28 (7): 1022.e9-1022.e16 被引量:14
标识
DOI:10.1016/j.cmi.2022.02.017
摘要

In difficult-to-treat infections such as nosocomial ventriculitis, meropenem exposure in the infected compartment is often uncertain but crucial for antibacterial effects. The aim of this study was to investigate the cerebrospinal fluid (CSF) penetration of meropenem in patients with nosocomial ventriculitis and to derive a nomograph to predict effective meropenem doses as a function of clinical parameters.Retrospective patient data including meropenem serum and CSF levels as well as CSF inflammation markers were analyzed using NONMEM to assess the general pharmacokinetics and CSF penetration. Monte Carlo simulations were used to evaluate different meropenem dosing regimens. Probability of target attainment (PTA) in CSF was assessed, and a nomograph to achieve a target twice the minimal inhibitory concentration (MIC) during the dosing interval (100 %fT > 2x MIC) was developed.A one-compartment model with meropenem clearance dependent on the estimated glomerular filtration rate (CKD-EPI eGFR, p < 0.001) best described meropenem serum pharmacokinetics of 51 critically ill patients. CSF penetration ratio was correlated with the amount of protein in CSF (p < 0.001), with higher CSF protein levels accounting for higher penetration ratios. Preserved renal function (CKD-EPI eGFR >50 mL/min/1.73 m2) and low CSF protein levels (<500 mg/L) resulted in 80% PTA 100 %fT >2xMIC) for a meropenem dose of 6 g/24 h.High interindividual variability in meropenem CSF concentration was observed in patients with nosocomial ventriculitis. A nomograph to predict the daily meropenem dose required for target attainment for a given eGFR and CSF protein count was developed.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
如意枫叶发布了新的文献求助10
1秒前
面壁思过应助m7m采纳,获得30
3秒前
3秒前
大模型应助猪猪hero采纳,获得10
3秒前
4秒前
FashionBoy应助科研通管家采纳,获得10
4秒前
CodeCraft应助科研通管家采纳,获得10
4秒前
czh应助科研通管家采纳,获得20
4秒前
科研通AI5应助科研通管家采纳,获得10
5秒前
顾矜应助科研通管家采纳,获得10
5秒前
5秒前
烟花应助科研通管家采纳,获得10
5秒前
bkagyin应助科研通管家采纳,获得10
5秒前
5秒前
科研通AI5应助科研通管家采纳,获得10
5秒前
5秒前
5秒前
小马甲应助科研通管家采纳,获得10
5秒前
wwwstt完成签到,获得积分10
6秒前
Lily完成签到,获得积分10
7秒前
7秒前
8秒前
700w完成签到 ,获得积分10
9秒前
10秒前
Zz发布了新的文献求助10
12秒前
gj发布了新的文献求助10
12秒前
猪猪hero发布了新的文献求助10
13秒前
感性的早晨完成签到,获得积分10
14秒前
Lucas应助忐忑的阑香采纳,获得10
15秒前
16秒前
周开心完成签到,获得积分10
18秒前
猪猪hero发布了新的文献求助10
18秒前
19秒前
23秒前
23秒前
JamesPei应助徐哈哈采纳,获得10
24秒前
猪猪hero发布了新的文献求助10
24秒前
thuuu完成签到,获得积分10
25秒前
gj完成签到,获得积分20
27秒前
香蕉妙菱发布了新的文献求助10
27秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
‘Unruly’ Children: Historical Fieldnotes and Learning Morality in a Taiwan Village (New Departures in Anthropology) 400
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 350
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3989242
求助须知:如何正确求助?哪些是违规求助? 3531393
关于积分的说明 11253753
捐赠科研通 3270010
什么是DOI,文献DOI怎么找? 1804868
邀请新用户注册赠送积分活动 882084
科研通“疑难数据库(出版商)”最低求助积分说明 809136