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therapeutic drug monitoring

  • Imipenem Population Pharmacokinetics: Therapeutic Drug Monitoring Data Collected in Critically Ill Patients with or without Extracorporeal Membrane Oxygenation
    Pharmacology
    Imipenem Population Pharmacokinetics: Therapeutic Drug Monitoring Data Collected in Critically Ill Patients with or without Extracorporeal Membrane Oxygenation

    Carbapenem pharmacokinetic (PK) profiles are significantly different in critically ill patients because of the drastic variability of the patients’ physiological parameters. Published population PK studies have mainly focused on specific diseases, and the majority of these studies had small sample sizes. The aim of this study was to develop a population PK model of imipenem in critically ill patients that estimated the influence of...

    Wenqian Chen, Dan Zhang, Wenwen Lian, Xiaoxue Wang, Wenwen Du, Zhu Zhang, Dongjie Guo, Xianglin Zhang, Qingyuan Zhan, Pengmei Li
  • Population Pharmacokinetics and Dosage Optimization of Linezolid in Patients with Liver Dysfunction
    Pharmacology
    Population Pharmacokinetics and Dosage Optimization of Linezolid in Patients with Liver Dysfunction

    Linezolid is the first synthetic oxazolidone agent to treat infections caused by Gram-positive pathogens. Infected patients with liver dysfunction (LD) are more likely to suffer from adverse reactions, such as thrombocytopenia, when standard-dose linezolid is used than patients with LD who did not use linezolid. Currently, pharmacokinetics data of linezolid in patients with LD are limited. This study aimed to characterize...

    Su-hua Zhang, Zhen-yu Zhu, Zi Chen, Ying Li, Yang Zou, Miao Yan, Yun Xu, Feng Wang, Mou-ze Liu, Min Zhang, Bi-kui Zhang
  • Early Bayesian Dose Adjustment of Vancomycin Continuous Infusion in Children in a Randomized Controlled Trial
    Pharmacology
    Early Bayesian Dose Adjustment of Vancomycin Continuous Infusion in Children in a Randomized Controlled Trial

    Methicillin-resistant staphylococcal infections are a global burden. Area under the concentration-time curve to MIC (AUC/MIC) ratio is the pharmacokinetic (PK) parameter that best predicts vancomycin efficacy. Its therapeutic range is narrow, difficult to achieve because of a wide intersubject variability, especially in children, and is not routinely targeted since the AUC is rarely available.

    Romain Berthaud, Sihem Benaboud, Déborah Hirt, Mathieu Genuini, Mehdi Oualha, Martin Castelle, Coralie Briand, Solène Artru, Lorenzo Norsa, Olivia Boyer, Frantz Foissac, Naïm Bouazza, Jean-Marc Tréluyer
  • Using State Transition Models To Explore How the Prevalence of Subtherapeutic Posaconazole Exposures Impacts the Clinical Utility of Therapeutic Drug Monitoring for Posaconazole Tablets and Oral Suspension
    Clinical Therapeutics
    Using State Transition Models To Explore How the Prevalence of Subtherapeutic Posaconazole Exposures Impacts the Clinical Utility of Therapeutic Drug Monitoring for Posaconazole Tablets and Oral Suspension

    Therapeutic drug monitoring (TDM) has been recommended in guidelines for patients receiving posaconazole oral suspension, but its utility in patients receiving posaconazole tablet, which has an improved bioavailability, remains unclear.

    Russell E. Lewis, Dimitrios P. Kontoyiannis, Pierluigi Viale, Eric M. Sarpong
  • Influence of Sustained Low-Efficiency Dialysis Treatment on Isavuconazole Plasma Levels in Critically Ill Patients
    Pharmacology
    Influence of Sustained Low-Efficiency Dialysis Treatment on Isavuconazole Plasma Levels in Critically Ill Patients

    Isavuconazole plasma concentrations were measured before and after sustained low-efficiency dialysis (SLED) treatment in 22 critically ill adult patients with probable invasive aspergillosis and underlying hematological malignancies. Isavuconazole levels were significantly lower after SLED treatment (5.73 versus 3.36 μg/ml; P < 0.001). However, even after SLED treatment, isavuconazole concentrations exceeded the in vivo...

    Tobias Lahmer, Gonzalo Batres Baires, Markus Heilmaier, Roland M. Schmid, Fritz Sörgel, Martina Kinzig, Wolfgang Huber, Ulrich Mayr, Sebastian Rasch
  • Low Central Nervous System Posaconazole Concentrations during Cerebral Phaeohyphomycosis
    Clinical Therapeutics
    Low Central Nervous System Posaconazole Concentrations during Cerebral Phaeohyphomycosis

    Posaconazole diffusion has been documented in various organs, which contrasts with the scarce data available for the human central nervous system (CNS). We analyzed posaconazole concentrations in plasma and multiple CNS specimens taken from a patient who received posaconazole because of cerebral phaeohyphomycosis. Low posaconazole concentrations were obtained in CNS specimens, with sample-to-plasma ratios between 5% and 22%.

    ...
    François Barde, Eliane Billaud, Lauriane Goldwirt, Catherine Horodyckid, Vincent Jullien, Fanny Lanternier, Philippe Lesprit, Lucie Limousin, Jérémie F. Cohen, Olivier Lortholary
  • Isavuconazole Diffusion in Infected Human Brain
    Pharmacology
    Isavuconazole Diffusion in Infected Human Brain

    We report the cases of a 39-year-old woman with chronic lymphocytic leukemia and a 21-year-old man with chronic granulomatous disease treated for cerebral aspergillosis. The patients required radical surgery for infection progression despite adequate isavuconazole plasma concentration or neurological complication. We thus decided to measure the brain isavuconazole concentration.

    Claire Rouzaud, Vincent Jullien, Anne Herbrecht, Bruno Palmier, Simona Lapusan, Marjolaine Morgand, Romain Guéry, Amélie Dureault, François Danion, Stéphanie Puget, Lauriane Goldwirt, Fanny Lanternier, Olivier Lortholary
  • Treatment by Posaconazole Tablets, Compared to Posaconazole Suspension, Does Not Reduce Variability of Posaconazole Trough Concentrations
    Pharmacology
    Treatment by Posaconazole Tablets, Compared to Posaconazole Suspension, Does Not Reduce Variability of Posaconazole Trough Concentrations

    The delayed-release tablet formulation of posaconazole (POS-tab) results in higher plasma POS trough concentrations (Cmin) than the oral suspension (POS-susp), which raises the question of the utility of therapeutic drug monitoring (TDM). We aimed to compare the variability of the POS Cmin for the two formulations and identify determinants of the POS-tab Cmin and its variability.

    Elodie Gautier-Veyret, Léa Bolcato, Matthieu Roustit, Stéphanie Weiss, Julia Tonini, Marie-Pierre Brenier-Pinchart, Muriel Cornet, Anne Thiebaut-Bertrand, Françoise Stanke-Labesque
  • Impact of Triazole Therapeutic Drug Monitoring Availability and Timing
    Clinical Therapeutics
    Impact of Triazole Therapeutic Drug Monitoring Availability and Timing

    Therapeutic drug monitoring (TDM) is an established strategy to optimize antifungal therapy with certain triazoles. While established relationships exist between concentration and safety or efficacy, the impact of TDM timing on outcomes is unknown. We report clinical outcomes, including antifungal exposure and mortality, in patients receiving institutional versus reference laboratory TDM.

    Erin K. McCreary, Meg Bayless, Ahn P. Van, Alexander J. Lepak, Donald A. Wiebe, Lucas T. Schulz, David R. Andes
  • Validation and Application of an HPLC-DAD Method for Routine Therapeutic Drug Monitoring of Ceftobiprole
    Pharmacology
    Validation and Application of an HPLC-DAD Method for Routine Therapeutic Drug Monitoring of Ceftobiprole

    Ceftobiprole is a fifth-generation cephalosporin approved for the treatment of pneumonia, with a broad antibacterial spectrum, including potent activity against methicillin-resistant Staphylococcus aureus. As for the other cephalosporins, high pharmacokinetic variability and concentration-dependent neurotoxicity are expected.

    Benjamin Lima, Sandra Bodeau, Marie-Charlotte Quinton, Cyril Leven, Anne-Sophie Lemaire-Hurtel, Youssef Bennis

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