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Hagihara M, Kato H, Hamada Y, Hirai J, Sakanashi D, Suematsu H, Nishiyama N, Koizumi Y, Yamagishi Y, Matsuura K, Mikamo H. Population pharmacokinetics of arbekacin in different infectious disease settings and evaluation of dosing regimens. J Infect Chemother 2016; 22:436-43. [PMID: 27260679 DOI: 10.1016/j.jiac.2016.03.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 02/05/2016] [Accepted: 03/15/2016] [Indexed: 10/21/2022]
Abstract
The efficacy of arbekacin in patients with MRSA infections is influenced by the peak concentration (Cpeak)/MIC ratio (≧8). A daily arbekacin dose of 4-6 mg/kg is primarily used for the treatment of MRSA infection. However, clinical pharmacokinetic studies of arbekacin that evaluate changes in patients with different infectious diseases have been limited. This study was to evaluate the pharmacokinetics of arbekacin in different infectious diseases and to evaluate its dosing regimens. This work describes a single-centre, retrospective study. The pharmacokinetic parameters of arbekacin were calculated from individual serum-concentration data using WinNonlin ver. 6.3. A total of 331 serum samples were obtained from 170 patients. Our drug concentration-time data were well described by a two-compartment open model. The final model showed that drug clearance was related to creatinine clearance and that the total distribution volume (Vd) was related to actual body weight and the presence of bacteremia. The individual Vd in bacteremia patients was significantly higher than those of other patients (bacteremia: 29.7 ± 0.5 L, pneumonia: 20.8 ± 0.4 L, other infections: 21.4 ± 0.4 L; p < 0.05). Additionally, Monte Carlo simulation showed that target (Cpeak/MIC ≧ 8) attainment was only 10.1%, even at a dose of 6 mg/kg, especially for MRSA bacteremia patients with an arbekacin MIC = 2 μg/mL. In conclusion, our study revealed that the Vd may be higher in bacteremia patients than in patients with other infectious diseases. Therefore, an increase in the daily dose of arbekacin should be considered for bacteremia patients.
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Affiliation(s)
- Mao Hagihara
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan; Department of Pharmacy, Aichi Medical University School of Hospital, Japan
| | - Hideo Kato
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan; Department of Pharmacy, Aichi Medical University School of Hospital, Japan
| | - Yukihiro Hamada
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan; Department of Pharmacy, Aichi Medical University School of Hospital, Japan
| | - Jun Hirai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan
| | - Daisuke Sakanashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroyuki Suematsu
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Naoya Nishiyama
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Katsuhiko Matsuura
- Department of Pharmacy, Aichi Medical University School of Hospital, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan.
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Okada K, Kimura T, Mikamo H, Kasahara K, Seki M, Takakura S, Tokimatsu I, Ohmagari N, Takahashi Y, Matsumoto K, Igarashi M, Kobayashi M, Hamada Y, Mochizuki T, Kimura M, Nishi Y, Tanigawara Y, Takesue Y. Clinical practice guidelines for therapeutic drug monitoring of arbekacin: a consensus review of the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring. J Infect Chemother 2013; 20:1-5. [PMID: 24486168 DOI: 10.1016/j.jiac.2013.08.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 08/02/2013] [Accepted: 08/07/2013] [Indexed: 11/27/2022]
Abstract
Arbekacin (ABK) was approved and widely used in Japan for treatment of patients infected with MRSA, and TDM was introduced in clinical practice. The Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring decided to develop a clinical practice guidelines for TDM of ABK for the following reasons. First, although the daily dose of 150-200 mg was approved in Japan, recent PK-PD studies revealed that higher serum concentration is required to achieve better clinical efficacy and several findings concerning the usefulness of higher dosage regimen have obtained recently. Second, although maximal concentrations that obtained immediately after the end of administration (Cmax) was generally adopted, the serum concentration at 1 h after initiation of administration [peak serum concentration (Cpeak)] proved to be more suitable as an efficacy indicator of aminoglycosides. Lastly, as ABK is approved only in Japan, no international practice guideline for TDM has not been available in ABK to date. This guideline evaluated the scientific data associated with serum ABK monitoring and provided recommendations based on the available evidence. Potential limitations of this guideline, however, include the findings that few prospective clinical trials of TDM of ABK are available in the treatment of MRSA infections and that most of the published literature describes observational studies.
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Affiliation(s)
- Kenji Okada
- Department of Pharmacy, Tokyo Women's Medical University Hospital, Japan; Sectional Committee of Practice Guidelines for TDM; Antimicrobial Agents, The Japanese Society of Therapeutic Drug Monitoring, Japan
| | - Toshimi Kimura
- Department of Pharmacy, Tokyo Women's Medical University Hospital, Japan; Sectional Committee of Practice Guidelines for TDM; Antimicrobial Agents, The Japanese Society of Therapeutic Drug Monitoring, Japan
| | - Hiroshige Mikamo
- Department of Infection Control and Prevention, Aichi Medical University, Graduate School of Medicine, Japan; Committee of Practice Guidelines for TDM of Antimicrobial Agents, Japanese Society of Chemotherapy, Japan
| | - Kei Kasahara
- Center for Infectious Diseases, Nara Medical University, Japan; Committee of Practice Guidelines for TDM of Antimicrobial Agents, Japanese Society of Chemotherapy, Japan
| | - Masafumi Seki
- Division of Infection Control and Prevention, Osaka University Medical Hospital, Japan; Committee of Practice Guidelines for TDM of Antimicrobial Agents, Japanese Society of Chemotherapy, Japan
| | - Shunji Takakura
- Department of Infection Control and Prevention, Kyoto University Hospital, Japan; Committee of Practice Guidelines for TDM of Antimicrobial Agents, Japanese Society of Chemotherapy, Japan
| | - Issei Tokimatsu
- Internal Medicine II, Oita University Faculty of Medicine, Japan; Committee of Practice Guidelines for TDM of Antimicrobial Agents, Japanese Society of Chemotherapy, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Japan; Committee of Practice Guidelines for TDM of Antimicrobial Agents, Japanese Society of Chemotherapy, Japan
| | - Yoshiko Takahashi
- Department of Pharmacy, Hyogo Medical College Hospital, Japan; Committee of Practice Guidelines for TDM of Antimicrobial Agents, Japanese Society of Chemotherapy, Japan
| | - Kazuaki Matsumoto
- Department of Clinical Pharmacy and Pharmacology, Graduate School of Medical and Dental Sciences, Kagoshima University, Japan; Committee of Practice Guidelines for TDM of Antimicrobial Agents, Japanese Society of Chemotherapy, Japan
| | - Masahiro Igarashi
- Department of Pharmacy, Toranomon Hospital, Japan; Sectional Committee of Practice Guidelines for TDM; Antimicrobial Agents, The Japanese Society of Therapeutic Drug Monitoring, Japan
| | - Masahiro Kobayashi
- Department of Pharmacy, Kitasato University Hospital, Japan; Sectional Committee of Practice Guidelines for TDM; Antimicrobial Agents, The Japanese Society of Therapeutic Drug Monitoring, Japan
| | - Yukihiro Hamada
- Department of Infection Control and Prevention, Aichi Medical University, Graduate School of Medicine, Japan; Sectional Committee of Practice Guidelines for TDM; Antimicrobial Agents, The Japanese Society of Therapeutic Drug Monitoring, Japan
| | - Takahiro Mochizuki
- Department of Pharmacy, Shizuoka Cancer Center, Japan; Sectional Committee of Practice Guidelines for TDM; Antimicrobial Agents, The Japanese Society of Therapeutic Drug Monitoring, Japan
| | - Masao Kimura
- Department of Pharmacy, Aichi Medical University Hospital, Japan; Sectional Committee of Practice Guidelines for TDM; Antimicrobial Agents, The Japanese Society of Therapeutic Drug Monitoring, Japan
| | - Yoshifumi Nishi
- Department of Pharmacy, Kyorin University School of Medicine, Japan; Sectional Committee of Practice Guidelines for TDM; Antimicrobial Agents, The Japanese Society of Therapeutic Drug Monitoring, Japan
| | - Yusuke Tanigawara
- Keio University, School of Medicine, Department of Clinical Pharmacokinetics and Pharmacodynamics, Japan; Sectional Committee of Practice Guidelines for TDM; Antimicrobial Agents, The Japanese Society of Therapeutic Drug Monitoring, Japan
| | - Yoshio Takesue
- Department of Infection Control and Prevention, Hyogo Medical College Hospital, Japan; Committee of Practice Guidelines for TDM of Antimicrobial Agents, Japanese Society of Chemotherapy, Japan.
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