Ceftriaxone » Cumulative Fraction of Response » Percent time of free concentration above MIC

simulate_ceftriaxone_mc_cfr_ftime_above_mic(
  PATID,
  AGE,
  HEIGHT,
  WEIGHT,
  GENDER,
  CREATININE,
  MODEL,
  PCTABOVEMIC,
  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 ('Garot et al. (2011) - ICU, septic patients').

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').

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 ceftriaxone and comparator antimicrobial agents when tested against Escherichia isolates in the SENTRY program collected during 2013-2019 (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: Ceftriaxone

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: 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

Examples

if (FALSE) {
simulate_ceftriaxone_mc_cfr_ftime_above_mic(PATID = "Anonymous", 
    AGE = 85, HEIGHT = 170, 
    WEIGHT = 120, GENDER = "Male", 
    CREATININE = 1, MODEL = "Garot et al. (2011) - ICU, septic patients", 
    PCTABOVEMIC = 90, 
    CRCLCAP = "No cap", 
    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")), 
    MICDISTR = list("MICDISTR-0.015625" = list(
        0), "MICDISTR-0.03125" = list(
        0), "MICDISTR-0.0625" = list(
        66.3), "MICDISTR-0.125" = list(
        11.5), "MICDISTR-0.25" = list(
        2.2), "MICDISTR-0.5" = list(
        0.5), "MICDISTR-1" = list(
        0.4), "MICDISTR-2" = list(
        0.2), "MICDISTR-4" = list(
        0.2), "MICDISTR-8" = list(
        0.4), "MICDISTR-16" = list(
        18.2)))
}