PK/PD modelling : Clinical Implications

8th ISAP Educational Workshop, Glasgow, UK, May 10th, 2003

Click here to start


Table of Contents

PK/PD modelling : Clinical Implications

The problem ...

The problem ...

So, you need to know the ennemy ...

Which parameter are you going to use ?

The saga of the AUC / MIC vs Cmax / MIC ratio for fluoroquinolones ...

AUC24h / MIC = 125 : a magical number??

24h-AUC/MIC : actual data ...

24h-AUC/MIC : actual data ...

AUIC =125 : a magical number??

Example Target Controlled Dosing Ixacin

Is 125 good for all ??

PPT Slide

Breakpoint issues ...

?-lactams : T > MIC … but how much, how long, etc... ??

How much time above MIC ?

Here is a proposal ...

The same for all microorganims ?

The same for all ?-lactams ?

PPT Slide

Variation of PK in individuals...

Variation of PK in individuals...

Monte Carlo Simulations in pk/pd (1)

Target Attainment Rates (TARs)

Target Attainment Rates (TARs)

Monte Carlo Simulations in pk/pd (2)

Target Attainment Rates (TARs)

Needed for TAR

Cumulative Fraction of Response

Cumulative dose response and MIC distribution

Pharmacodynamic properties of beta-lactams

Target Concentration : continuous infusion

Target Concentration and continuous infusion : which is the minimal concentration … ?

Maximal efficacy of a penem in broth… (ertapenem)

PPT Slide

Continuous Infusion Pharmacokinetic Considerations

Dose Calculations for continuous infusion

PPT Slide

Example Target Controlled Dosing for Cefticostix

PPT Slide

Cost comparisons : vs 4 g by continuous infusion (CI) vs 2 g q8h (CA) for 51 patients in ICU

Problems with continuous infusion ...

Ceftazidime concentrations ICU patients

Ceftazidime concentrations in ICU patients (successive determinations)

Drug instability ...

Conclusions … or what do you need with fluoroquinolones, ???- lactams, etc… ?

Author: J.W. Mouton and P.M. Tulkens

Email: webmaster@isap.org

Home Page: http://www.isap.org/slides.htm

Other information:
These slides are for information only. Do not make public use of them without the autorization of their author and of ISAP. Send your requests to <webmaster@isap.org>

Download presentation as PDF file