Piperacillin & Tazobactam » Cumulative Fraction of Response » Free minimum concentration to MIC ratio

simulate_piperacillin_tazobactam_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 ('Felton et al. (2014) - ICU' or 'Patel et. al. (2010) - 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 piperacillin-tazobactam and comparator antimicrobial agents when tested against Pseudomonas aeruginosa 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: Piperacillin & Tazobactam

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

  • Felton, T. W. et al. (2014): Individualization of Piperacillin Dosing for Critically Ill Patients: Dosing Software To Optimize Antimicrobial Therapy. In. Antimicrobial Agents and Chemotherapy. https://aac.asm.org/content/58/7/4094

  • Patel, N. et al. (2010): Identification of Optimal Renal Dosage Adjustments for Traditional and Extended-Infusion Piperacillin-Tazobactam Dosing Regimens in Hospitalized Patients. In. Antimicrobial Agents and Chemotherapy. https://aac.asm.org/content/54/1/460

Examples

if (FALSE) {
simulate_piperacillin_tazobactam_mc_cfr_fcmin_mic_ratio(PATID = "Anonymous", 
    AGE = 35, HEIGHT = 155, 
    WEIGHT = 55, GENDER = "Female", 
    CREATININE = 1.2, 
    MODEL = "Felton et al. (2014) - ICU", 
    CMINPERMIC = 2, CRCLCAP = "No cap", 
    REGIMENS = list(list(
        DOSE = 3375, 
        INTERVAL = 6, 
        TINF = 0.5, set = "REGIMEN")), 
    MICDISTR = list("MICDISTR-0.5" = list(
        3.4), "MICDISTR-1" = list(
        1.7), "MICDISTR-2" = list(
        7), "MICDISTR-4" = list(
        40.9), "MICDISTR-8" = list(
        14.4), "MICDISTR-16" = list(
        9.6), "MICDISTR-32" = list(
        6.1), "MICDISTR-64" = list(
        4.9), "MICDISTR-128" = list(
        11.9)))
}