Examination of Optimized Pharmacodynamic Dosing Strategy for Biapenem using Monte Carlo Simulation

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  • モンテカルロシミュレーションを用いた，高齢者に対するビアペネムの最適な投与方法の検討
  • モンテカルロ シミュレーション オ モチイタ コウレイシャ ニ タイスル ビアペネム ノ サイテキナ トウヨ ホウホウ ノ ケントウ

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The efficacy and safety of Biapenem (BIPM) for respiratory tract infection was investigated in 19 elderly patients at Nagasaki Medical Center. The dosage volume of administered BIPM was 6.7mg/kg/day. The result of the calculation using a population average parameter (2 compartment model) to estimate the concentration in blood of BIPM, with Cmax 18.40±4.35μg/ml, T1/2/β1.58±0.37hr, CLtot 6.64±2.581/hr, and AUC was 49.98±14.00μg·hr/ml. There was no improvement of CRP after day 7, but WBC (P<0.0001) and temperature (P<0.001) improved to a normal level. As for renal function, Scr increased in one of the 19 cases. In the case of P. aeruginosa, with MIC90 (16μg/ml), the probability (TA%) that %TAM would reach 50% was 8.6%, and the probability (TA%) that %TAM would reach 30% was 29.3%. In addition, with MIC50 (1μg/ml), the probability (TA%) that %TAM would reach 50% was 56.2%, and the probability (TA%) that %TAM would reach 30% was 90.3%. In the case of an infectious disease by P, aeruginosa, it is thought that loading of dosage or increase in the number of times administered is necessary. However, administration of BIPM to the elderly whereby metabolism and excretion function are aggravated requires more careful administration, and examination of a further administration design is necessary.

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