1
|
Nonoshita K, Suzuki Y, Tanaka R, Kaneko T, Ohchi Y, Sato Y, Yasuda N, Goto K, Kitano T, Itoh H. Population pharmacokinetic analysis of doripenem for Japanese patients in intensive care unit. Sci Rep 2020; 10:22148. [PMID: 33335198 PMCID: PMC7747597 DOI: 10.1038/s41598-020-79076-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 11/25/2020] [Indexed: 12/01/2022] Open
Abstract
We aimed to construct a novel population pharmacokinetics (PPK) model of doripenem (DRPM) for Japanese patients in intensive care unit, incorporating the clearance of DRPM by continuous renal replacement therapy (CRRT). Twenty-one patients treated with DRPM (0.25 or 0.5 g) by intravenous infusion over 1 h were included in the study. Nine of the 21 patients were receiving CRRT. Plasma samples were obtained before and 1, 2, 4, 6 and 8 h after the first DRPM administration. PPK analysis was conducted by nonlinear mixed effects modeling using a two-compartment model. Total clearance (CLtotal) in the model was divided into CRRT clearance (CLCRRT) and body clearance (CLbody). The final model was: CLtotal (L h-1) = CLbody(non-CRRT) = 3.65 × (Ccr/62.25)0.64 in the absence of CRRT, or = CLbody(CRRT) + CLCRRT = 2.49 × (Ccr/52.75)0.42 + CLCRRT in the presence of CRRT; CLCRRT = QE × 0.919 (0.919 represents non-protein binding rate of DRPM); V1 (L) = 10.04; V2 (L) = 8.13; and Q (L h-1) = 3.53. Using this model, CLtotal was lower and the distribution volumes (V1 and V2) tended to be higher compared to previous reports. Also, Ccr was selected as a significant covariate for CLbody. Furthermore, the contribution rate of CLCRRT to CLtotal was 30-40%, suggesting the importance of drug removal by CRRT. The population analysis model used in this study is a useful tool for planning DRPM regimen and administration. Our novel model may contribute greatly to proper use of DRPM in patients requiring intensive care.
Collapse
Affiliation(s)
- Ko Nonoshita
- Department of Clinical Pharmacy, Oita University Hospital, Hasama-machi, Oita, Japan.
| | - Yosuke Suzuki
- Department of Clinical Pharmacy, Oita University Hospital, Hasama-machi, Oita, Japan
| | - Ryota Tanaka
- Department of Clinical Pharmacy, Oita University Hospital, Hasama-machi, Oita, Japan
| | - Tetsuya Kaneko
- Department of Clinical Pharmacy, Oita University Hospital, Hasama-machi, Oita, Japan
| | - Yoshifumi Ohchi
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, Oita University, Hasama-machi, Oita, Japan
| | - Yuhki Sato
- Department of Clinical Pharmacy, Oita University Hospital, Hasama-machi, Oita, Japan
| | - Norihisa Yasuda
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, Oita University, Hasama-machi, Oita, Japan
| | - Koji Goto
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, Oita University, Hasama-machi, Oita, Japan
| | - Takaaki Kitano
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, Oita University, Hasama-machi, Oita, Japan
| | - Hiroki Itoh
- Department of Clinical Pharmacy, Oita University Hospital, Hasama-machi, Oita, Japan
| |
Collapse
|
2
|
Matsuo Y, Matsumoto S, Wajima T, Matsubara K. Pharmacokinetic modeling and simulation for dose rationale of doripenem in neonates and infants. Drug Metab Pharmacokinet 2020; 35:145-150. [PMID: 31969257 DOI: 10.1016/j.dmpk.2019.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 09/25/2019] [Accepted: 10/15/2019] [Indexed: 11/18/2022]
Abstract
The aims of this study were to construct a population pharmacokinetic model of doripenem in neonates and infants and to assess the dosing regimen for patients <3 months of age using Monte-Carlo pharmacokinetic/pharmacodynamic (PKPD) simulations. In the population pharmacokinetic analysis using 187 plasma concentrations from 47 neonates and infants, a two-compartment model well described plasma doripenem concentrations with the most significant covariates of chronological age and gestational age identified for the pharmacokinetics of doripenem. Monte-Carlo simulations suggested that the selected dosages for neonates and infants based on chronological age and gestational age (5 or 10 mg/kg) would provide ≥90% target attainment of 40%fT>MIC against MIC of 2 μg/mL in all age groups. These results would be useful for understanding the PKPD characteristics of doripenem, which could provide essential information on optimal therapeutic treatment for neonates and infants.
Collapse
Affiliation(s)
- Yumiko Matsuo
- Clinical Pharmacology & Pharmacokinetics, Project Management Department, Shionogi & Co., Ltd, Japan.
| | - Sayaka Matsumoto
- Clinical Pharmacology & Pharmacokinetics, Project Management Department, Shionogi & Co., Ltd, Japan
| | - Toshihiro Wajima
- Clinical Pharmacology & Pharmacokinetics, Project Management Department, Shionogi & Co., Ltd, Japan
| | - Kazuo Matsubara
- Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Japan
| |
Collapse
|