Cefepime dosing regimens in critically ill patients receiving continuous renal replacement therapy: a Monte Carlo simulation study

Chaijamorn, Weerachai; Charoensareerat, Taniya; Srisawat, Nattachai; Pattharachayakul, Sutthiporn; Boonpeng, Apinya

doi:10.1186/s40560-018-0330-8

Journal of Intensive Care

Table 3 PTAs of all recommended cefepime dosing regimens for Gram-negative infections in two CRRT modalities with different effluent rates and various MICs

From: Cefepime dosing regimens in critically ill patients receiving continuous renal replacement therapy: a Monte Carlo simulation study

Cefepime dosing regimen	Pre-dilution CVVH					CVVHD
	Effluent rates (mL/kg/h)	PTA (%)				Effluent rates (mL/kg/h)	PTA (%)
		MIC (mg/L)					MIC (mg/L)
		1	2	4	8		1	2	4	8
250 mg Q8H	10	98.62	53.10	0.22	0.00	10	98.64	49.90	0.04	0.00
	15	98.50	43.78	0.02	0.00	15	98.46	40.86	0.00	0.00
	20	98.02	36.10	0.00	0.00	20	97.68	29.3	0.00	0.00
	25	98.12	27.06	0.00	0.00	25	96.52	16.58	0.00	0.00
	35	96.42	13.72	0.00	0.00	35	91.62	3.52	0.00	0.00
750 mg LD then 500 mg Q12H	10	100	95.24	20.88	0.00	10	99.98	94.42	17.96	0.00
	15	100	91.44	11.00	0.00	15	99.98	89.06	8.12	0.00
	20	99.96	86.86	5.12	0.00	20	99.88	80.80	1.54	0.00
	25	99.80	81.28	1.64	0.00	25	99.52	71.46	0.14	0.00
	35	99.38	66.48	0.10	0.00	35	98.72	42.06	0.00	0.00
1 g LD then 500 mg Q12H	10	100	98.42	38.36	0.00	10	100	98.02	33.30	0.00
	15	99.96	96.88	25.34	0.00	15	99.98	95.60	18.52	0.00
	20	99.96	94.00	14.22	0.00	20	99.86	90.26	7.24	0.00
	25	99.90	90.24	6.86	0.00	25	99.84	83.04	1.96	0.00
	35	99.74	80.30	1.00	0.00	35	99.08	58.44	0.04	0.00
750 mg Q12H	10	100	99.30	51.16	0.06	10	100	99.18	47.34	0.00
	15	100	98.70	38.72	0.00	15	100	98.36	33.6	0.00
	20	100	97.98	29.42	0.00	20	100	96.66	20.50	0.00
	25	99.98	96.78	18.30	0.00	25	99.94	93.58	8.90	0.00
	35	99.86	91.54	6.72	0.00	35	99.76	80.52	0.98	0.00
1 g Q12H	10	100	99.96	83.58	6.30	10	100	100	82.72	5.52
	15	100	99.92	76.62	2.42	15	100	99.86	72.94	1.12
	20	100	99.82	68.78	0.62	20	100	99.52	61.14	0.06
	25	100	99.52	61.18	0.10	25	100	99.00	47.26	0.00
	35	99.98	98.78	42.26	0.00	35	99.94	96.74	19.50	0.00
750 mg Q8H	10	100	99.98	92.48	19.38	10	100	99.98	92.08	16.34
	15	100	99.98	90.78	12.92	15	100	100	87.92	8.86
	20	100	99.94	86.92	6.56	20	100	99.96	83.70	3.14
	25	100	99.98	83.92	0.26	25	100	99.96	77.50	0.56
	35	100	99.98	73.96	0.52	35	100	99.88	54.20	0.00
1 g LD then 750 mg Q8H	10	100	100	96.12	28.10	10	100	100	95.98	26.90
	15	100	100	94.92	18.86	15	100	100	94.26	14.62
	20	100	100	93.08	11.82	20	100	99.98	91.14	7.50
	25	100	100	90.62	7.00	25	100	100	84.68	1.98
	35	100	99.98	82.84	1.30	35	100	99.92	66.64	0.02
1 g Q8H	10	100	100	98.58	54.02	10	100	100	98.60	51.60
	15	100	100	98.20	45.68	15	100	100	98.14	40.96
	20	100	100	97.96	35.56	20	100	100	97.54	29.68
	25	100	100	97.96	29.46	25	100	100	96.50	18.22
	35	100	100	96.56	13.88	35	100	100	91.62	3.58
1.75 g then 1.5 g Q 8 H	10	100	100	100	94.38	10	100	100	100	94.28
	15	100	100	100	92.44	15	100	100	99.98	91.72
	20	100	100	100	90.04	20	100	100	99.98	88.04
	25	100	100	99.96	87.46	25	100	100	99.92	79.64
	35	100	100	99.96	78.62	35	100	100	99.98	61.84
2 g LD then 1.5 g Q8H	10	100	100	100	96.04	10	100	100	100	95.3
	15	100	100	100	95.24	15	100	100	100	94.36
	20	100	100	99.98	93.26	20	100	100	99.98	90.66
	25	100	100	100	90.50	25	100	100	99.98	84.60
	35	100	100	100	82.96	35	100	100	99.96	66.70
1.75 g Q8H	10	100	100	100	96.94	10	100	100	100	96.22
	15	100	100	100	96.34	15	100	100	100	95.70
	20	100	100	100	95.42	20	100	100	100	94.64
	25	100	100	100	94.58	25	100	100	100	92.00
	35	100	100	100	89.48	35	100	100	99.98	77.76
2 g LD then 1.75 g Q8H	10	100	100	100	97.80	10	100	100	100	97.44
	15	100	100	100	97.36	15	100	100	99.98	96.60
	20	100	100	100	96.70	20	100	100	100	95.46
	25	100	100	99.98	95.90	25	100	100	100	93.20
	35	100	100	100	92.52	35	100	100	99.98	82.22
2 g Q8H	10	100	100	100	98.60	10	100	100	100	98.36
	15	100	100	100	98.32	15	100	100	100	98.18
	20	100	100	100	98.44	20	100	100	100	97.54
	25	100	100	100	98.00	25	100	100	100	97.02
	35	100	100	100	96.66	35	100	100	100	91.24

PTA probability of target attainment, CVVH continuous venovenous hemofiltration, CVVHD continuous venovenous hemodialysis, LD loading dose

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ISSN: 2052-0492

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