Limited sampling strategies for therapeutic drug monitoring of amikacin and kanamycin in patients with multidrug-resistant tuberculosis

•Amikacin and kanamycin are both used in the treatment of multidrug-resistant tuberculosis.•One combined model was designed based on the pooled data of all 30 plasma concentration curves.•An optimal sampling strategy was developed based on this combined model.•Sampling at 1h and 4h after drug admini...

Celý popis

Uloženo v:
Podrobná bibliografie
Vydáno v:International journal of antimicrobial agents Ročník 46; číslo 3; s. 332 - 337
Hlavní autoři: Dijkstra, J.A., van Altena, R., Akkerman, O.W., de Lange, W.C.M., Proost, J.H., van der Werf, T.S., Kosterink, J.G.W., Alffenaar, J.W.C.
Médium: Journal Article
Jazyk:angličtina
Vydáno: Netherlands Elsevier B.V 01.09.2015
Témata:
Adult
Amikacin
Amikacin - pharmacokinetics
Amikacin - therapeutic use
Antitubercular Agents - pharmacokinetics
Antitubercular Agents - therapeutic use
Biostatistics
Drug Monitoring - methods
drugs
Female
Humans
Infectious Disease
Kanamycin
Kanamycin - pharmacokinetics
Kanamycin - therapeutic use
Limited sampling
Male
Models, Statistical
monitoring
multiple drug resistance
patients
Pharmacokinetic model
Pharmacokinetics
prediction
Retrospective Studies
Specimen Handling - methods
therapeutics
toxicity
Tuberculosis
Tuberculosis, Multidrug-Resistant - drug therapy
Young Adult
Kanamycin
Pharmacokinetic model
Tuberculosis
Amikacin
Pharmacokinetics
Limited sampling
ISSN:0924-8579, 1872-7913, 1872-7913
On-line přístup:Získat plný text
Tagy: Přidat tag
Žádné tagy, Buďte první, kdo vytvoří štítek k tomuto záznamu!
Popis
Shrnutí:•Amikacin and kanamycin are both used in the treatment of multidrug-resistant tuberculosis.•One combined model was designed based on the pooled data of all 30 plasma concentration curves.•An optimal sampling strategy was developed based on this combined model.•Sampling at 1h and 4h after drug administration allows a reliable Bayesian estimation of the AUC0–24h using the developed model. Amikacin and kanamycin are considered important and effective drugs in the treatment of multidrug-resistant tuberculosis (MDR-TB). Unfortunately, the incidence of toxicity is high and is related to elevated drug exposure. In order to achieve a balance between efficacy and toxicity, a population pharmacokinetic (PPK) model may help to optimise drug exposure. Patients with MDR-TB who had received amikacin or kanamycin as part of their treatment and who had routinely received therapeutic drug monitoring were evaluated. A PPK model was developed and subsequently validated. Using this model, a limited sampling model was developed. Eleven patients receiving amikacin and nine patients receiving kanamycin were included in this study. The median observed 24-h area under the concentration–time curve (AUC0–24h) was 77.2mgh/L [interquartile range (IQR) 64.7–96.2mgh/L] for amikacin and 64.1mgh/L (IQR 55.6–92.1mgh/L) for kanamycin. The PPK model was developed and validated using n−1 cross-validation. A robust population model was developed that is suitable for predicting the AUC0–24h of amikacin and kanamycin. This model, in combination with the limited sampling strategy developed, can be used in daily routine to guide dosing but also to assess AUC0–24h in phase 3 studies.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:0924-8579
1872-7913
1872-7913
DOI:10.1016/j.ijantimicag.2015.06.008