Artículo de revista
Estimation of the Probability to Target Attainment to the Pharmacokinetic/ Pharmacodynamic Index of Ertapenem in Elderly Inpatients
Fecha
2020Registro en:
Indian Journal of Pharmaceutical Education and Research |Vol 54 | Issue 4 | Oct-Dec, 2020
10.5530/ijper.54.4.215
Autor
Palma Vallejos, Daniel
Vega, Elena María
Gai Hernández, María
Institución
Resumen
Background: Infectious diseases are one of the most causes of hospitalization and
death in adults in the elderly and this population is prone to develop complications
and pharmacokinetic/pharmacodynamic changes. Objectives: To estimate the
probability to target attainment (PTA) to the pharmacokinetic/pharmacodynamic (PK/
PD) index of ertapenem for older adults hospitalized in a medical ward. Materials and
Methods: In a prospective and observational analysis, free drug concentrations of
ertapenem were determined in older adults hospitalized at medical ward setting and
compared with EUCAST epidemiological cut-off values (ECOFF: 0.064 mg/L) to extreme
MIC (64 mg/L), using 1000 Monte Carlo simulations to estimate therapeutic target
attainment (%f T ≥ MIC ≥ 40%). Results: Five elderly inpatients with renal impairment
and hypoalbuminemia were included with eight samples per patient (n=40 observations).
Monte Carlo simulations shown free ertapenem concentrations attain to PK/PD index on
the MIC interval from 0.064 to 4 mg/L. Conclusion: If pathogen MICs are ≥ 4 mg/L, elderly
inpatients could not attain to the PK/PD target of ertapenem in medical ward setting,
rising probability of antimicrobial resistance and therapeutic failure in this population.