Cefepime » CFR » fCmin/MIC

Cefepime » Cumulative Fraction of Response » Free minimum concentration to MIC ratio

simulate_cefepime_mc_cfr_fcmin_mic_ratio(
  PATID,
  AGE,
  HEIGHT,
  WEIGHT,
  GENDER,
  CREATININE,
  MODEL,
  CMINPERMIC,
  CRCLCAP,
  REGIMENS,
  MICDISTR
)

Arguments

PATID	Patient Identifier. User-provided free text (such as patient id, name or alias) to identify related simulations. Must be provided as string.
AGE	Age. Age of the patient in years. Must be provided as numeric (min. 18, max. 120 year).
HEIGHT	Height. Height of the patient. Must be provided as numeric (min. 100, max. 250 cm).
WEIGHT	Weight. Actual body weight of the patient. Must be provided as numeric (min. 20, max. 500 kg).
GENDER	Sex. Patient's sex for clinical decision-making. Must be provided as string ('Male' or 'Female').
CREATININE	Creatinine. Serum creatinine. Must be provided as numeric (min. 0.01, max. 15 mg/dL).
MODEL	Model for population of interest. Pharmacokinetic model to be used for specific patient type during simulations. Must be provided as string ('Nicasio et al. (2009) - ICU' or 'Tam et al. (2003) - General ward').
CMINPERMIC	Minimum concentration to MIC ratio target. The PK/PD target can be provided as minimum concentration to minimum inhibitory concentration ratio (Cmin/MIC). Must be provided as numeric (min. 0.1, max. 50 ).
CRCLCAP	Capping Creatinine Clearance. Whether to use capping for creatinine clearance. Must be provided as string ('No cap', '120 ml/min', '130 ml/min', '140 ml/min' or '150 ml/min').
REGIMENS	Dosing Regimens. List of dosing regimens to be used in simulating target attainment, from which the dosing regimen with the smallest absolute difference from the desired target will be automatically selected. Must be provided as list of 1-8 'REGIMEN' values. Use the regimen helper function to define the REGIMEN values.
MICDISTR	MIC distribution. Non-cumulative MIC distribution of organism for the given antibiotic at the specified MICs provided as percentages with a sum of 100%. MIC distribution of cefepime and comparator antimicrobial agents when tested against Enterobacter isolates in the SENTRY program collected during 2018 (mg/L). Dataset provided by JMI Laboratories and the SENTRY Antimicrobial Surveillance Program, available at <a href="http://sentry-mvp.jmilabs.com" target="_new">sentry-mvp.jmilabs.com</a>. Must be provided as set.

Details

Drug: Cefepime

Method: Monte Carlo simulation on the proportion of the population achieving a certain pharmacodynamic index value, given the minimum inhibitory concentration (MIC) distribution of the target microorganism(s).

PK/PD target: Free minimum concentration (mg/L) to minimum inhibitory concentration ratio (mg/L).

References

• Nicasio et al. (2009): Population Pharmacokinetics of High-Dose, Prolonged-Infusion Cefepime in Adult Critically Ill Patients with Ventilator-Associated Pneumonia. In. Antimicrobial Agents and Chemotherapy. https://pubmed.ncbi.nlm.nih.gov/19188394/

• Tam et al. (2003): Pharmacokinetics and Pharmacodynamics of Cefepime in Patients with Various Degrees of Renal Function. In. Antimicrobial Agents and Chemotherapy. https://pubmed.ncbi.nlm.nih.gov/12760858/

Examples

if (FALSE) {
simulate_cefepime_mc_cfr_fcmin_mic_ratio(PATID = "Anonymous", 
    AGE = 75, HEIGHT = 160, 
    WEIGHT = 105, GENDER = "Male", 
    CREATININE = 1, MODEL = "Nicasio et al. (2009) - ICU", 
    CMINPERMIC = 4, CRCLCAP = "No cap", 
    REGIMENS = list(list(
        DOSE = 1000, 
        INTERVAL = 8, 
        TINF = 0.5, set = "REGIMEN")), 
    MICDISTR = list("MICDISTR-0.0078125" = list(
        0), "MICDISTR-0.015625" = list(
        0.8), "MICDISTR-0.03125" = list(
        21.4), "MICDISTR-0.0625" = list(
        33.9), "MICDISTR-0.125" = list(
        12.8), "MICDISTR-0.25" = list(
        6), "MICDISTR-0.5" = list(
        3.5), "MICDISTR-1" = list(
        3.8), "MICDISTR-2" = list(
        5), "MICDISTR-4" = list(
        3.5), "MICDISTR-8" = list(
        2), "MICDISTR-16" = list(
        1.2), "MICDISTR-32" = list(
        1), "MICDISTR-64" = list(
        1.7), "MICDISTR-128" = list(
        0.8), "MICDISTR-256" = list(
        0.9), "MICDISTR-512" = list(
        1.7)))
}