Ceftriaxone » Bayesian adaptive dosing » Percent time of free concentration above MIC

simulate_ceftriaxone_bayesian_ftime_above_mic(
  PATID,
  AGE,
  HEIGHT,
  WEIGHT,
  GENDER,
  MODEL,
  MIC,
  PCTABOVEMIC,
  CRCLCAP,
  HISTORY,
  REGIMENS
)

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').

MODEL

Model for population of interest. Pharmacokinetic model to be used for specific patient type during simulations. Must be provided as string ('Garot et al. (2011) - ICU, septic patients').

MIC

MIC. Minimum Inhibitory Concentration (MIC). Must be provided as numeric (min. 0.01, max. 1024 mg/L).

PCTABOVEMIC

Percent of time target that the drug concentration is above MIC. The PK/PD target can be provided as the percent of time that the drug concentration is above the minimum inhibitory concentration (% T > MIC). Must be provided as numeric (min. 5, max. 100 %).

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').

HISTORY

Historical Records. Must be provided as list of 3-48 'HISTCREATININE', 'HISTDOSE' or 'HISTCONCENTRATION' values.

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 1-20 'REGIMEN' values. Use the regimen helper function to define the REGIMEN values.

Details

Drug: Ceftriaxone

Method: Estimate the pharmacokinetic parameters of the patient from past concentrations with Bayesian inverse modeling, then use that information to predict the steady state concentrations for multiple dosing regimens and select the optimal one, with regard to the target pharmacodynamic index.

PK/PD target: The percent of time that the free concentration is above the minimum inhibitory concentration.

References

  • Garot, Denis et al. (2011): Population pharmacokinetics of ceftriaxone in critically ill septic patients: a reappraisal. In. British Journal of Clinical Pharmacology. https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2125.2011.04005.x

  • K. Soetaert, T. Petzoldt (2010): Inverse Modelling, Sensitivity and Monte Carlo Analysis in R Using Package FME. In. Journal of Statistical Software. https://www.jstatsoft.org/article/view/v033i03

Examples

if (FALSE) {
simulate_ceftriaxone_bayesian_ftime_above_mic(PATID = "Anonymous", 
    AGE = 65, HEIGHT = 175, 
    WEIGHT = 75, GENDER = "Female", 
    MODEL = "Garot et al. (2011) - ICU, septic patients", 
    MIC = 1, PCTABOVEMIC = 90, 
    CRCLCAP = "No cap", 
    HISTORY = list(list(
        DATETIME = structure(1601870400, class = c("POSIXct", 
        "POSIXt"), tzone = ""), 
        DOSE = 2000, 
        TINF = 0.5, set = "HISTDOSE"), 
        list(DATETIME = structure(1601866800, class = c("POSIXct", 
        "POSIXt"), tzone = ""), 
            CREATININE = 1, 
            set = "HISTCREATININE"), 
        list(DATETIME = structure(1601881200, class = c("POSIXct", 
        "POSIXt"), tzone = ""), 
            CONCENTRATION = 12, 
            set = "HISTCONCENTRATION"), 
        list(DATETIME = structure(1601892000, class = c("POSIXct", 
        "POSIXt"), tzone = ""), 
            CONCENTRATION = 9, 
            set = "HISTCONCENTRATION")), 
    REGIMENS = list(list(
        DOSE = 500, INTERVAL = 12, 
        TINF = 0.5, set = "REGIMEN"), 
        list(DOSE = 500, 
            INTERVAL = 24, 
            TINF = 0.5, 
            set = "REGIMEN"), 
        list(DOSE = 1000, 
            INTERVAL = 12, 
            TINF = 0.5, 
            set = "REGIMEN"), 
        list(DOSE = 1000, 
            INTERVAL = 24, 
            TINF = 0.5, 
            set = "REGIMEN"), 
        list(DOSE = 1500, 
            INTERVAL = 12, 
            TINF = 0.5, 
            set = "REGIMEN"), 
        list(DOSE = 1500, 
            INTERVAL = 24, 
            TINF = 0.5, 
            set = "REGIMEN"), 
        list(DOSE = 2000, 
            INTERVAL = 12, 
            TINF = 0.5, 
            set = "REGIMEN"), 
        list(DOSE = 2000, 
            INTERVAL = 24, 
            TINF = 0.5, 
            set = "REGIMEN")))
}