Population pharmacokinetic analysis of doripenem for Japanese patients in intensive care unit

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 in...

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Autores principales: Ko Nonoshita, Yosuke Suzuki, Ryota Tanaka, Tetsuya Kaneko, Yoshifumi Ohchi, Yuhki Sato, Norihisa Yasuda, Koji Goto, Takaaki Kitano, Hiroki Itoh
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Publicado: Nature Portfolio 2020
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spelling oai:doaj.org-article:27a65936ad8a48dda497e5e8845681d82021-12-02T11:57:57ZPopulation pharmacokinetic analysis of doripenem for Japanese patients in intensive care unit10.1038/s41598-020-79076-62045-2322https://doaj.org/article/27a65936ad8a48dda497e5e8845681d82020-12-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-79076-6https://doaj.org/toc/2045-2322Abstract 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.Ko NonoshitaYosuke SuzukiRyota TanakaTetsuya KanekoYoshifumi OhchiYuhki SatoNorihisa YasudaKoji GotoTakaaki KitanoHiroki ItohNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 10, Iss 1, Pp 1-11 (2020)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Ko Nonoshita
Yosuke Suzuki
Ryota Tanaka
Tetsuya Kaneko
Yoshifumi Ohchi
Yuhki Sato
Norihisa Yasuda
Koji Goto
Takaaki Kitano
Hiroki Itoh
Population pharmacokinetic analysis of doripenem for Japanese patients in intensive care unit
description 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.
format article
author Ko Nonoshita
Yosuke Suzuki
Ryota Tanaka
Tetsuya Kaneko
Yoshifumi Ohchi
Yuhki Sato
Norihisa Yasuda
Koji Goto
Takaaki Kitano
Hiroki Itoh
author_facet Ko Nonoshita
Yosuke Suzuki
Ryota Tanaka
Tetsuya Kaneko
Yoshifumi Ohchi
Yuhki Sato
Norihisa Yasuda
Koji Goto
Takaaki Kitano
Hiroki Itoh
author_sort Ko Nonoshita
title Population pharmacokinetic analysis of doripenem for Japanese patients in intensive care unit
title_short Population pharmacokinetic analysis of doripenem for Japanese patients in intensive care unit
title_full Population pharmacokinetic analysis of doripenem for Japanese patients in intensive care unit
title_fullStr Population pharmacokinetic analysis of doripenem for Japanese patients in intensive care unit
title_full_unstemmed Population pharmacokinetic analysis of doripenem for Japanese patients in intensive care unit
title_sort population pharmacokinetic analysis of doripenem for japanese patients in intensive care unit
publisher Nature Portfolio
publishDate 2020
url https://doaj.org/article/27a65936ad8a48dda497e5e8845681d8
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