Relationship between Target Time above Minimum Inhibitory Concentration Achievement Rate of Meropenem Using Monte Carlo Simulation and In-Hospital Survival in Patients with <i>Pseudomonas aeruginosa</i> Bacteremia

• Main Authors: Hajime Nakashima (Author), Motoyasu Miyazaki (Author), Tsuneo Kuwamura (Author), Kazutaka Oda (Author), Yumi Haga (Author), Osamu Imakyure (Author)
• Format: Book
• Published: MDPI AG, 2024-02-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

<i>Pseudomonas aeruginosa</i> bacteremia is associated with a high mortality rate, and meropenem (MEPM) is commonly used to treat it. However, the relationship between the time above the minimum inhibitory concentration (<i>f</i>T_>MIC) of MEPM and its therapeutic efficacy in <i>P. aeruginosa</i> bacteremia has not been explored. This study aimed to investigate this relationship by defining the target % <i>f</i>T_>MIC of MEPM as 75%. The retrospective study spanned 14 years and included hospitalized patients treated with MEPM for <i>P. aeruginosa</i> bacteremia. Monte Carlo simulation was used to calculate the probability of target attainment (PTA) for each patient, and the threshold for a PTA of 75% <i>f</i>T_>MIC associated with in-hospital survival was determined using receiver operating characteristic (ROC) curves. The ROC curve-derived PTA associated with improved in-hospital survival was 65.0%, a significant finding in multivariate logistic regression analysis adjusted for patient background factors (odds ratio: 20.49, 95% confidence interval: 3.02-245.23, <i>p</i> = 0.005). This result suggests a dosing regimen that achieves a PTA of at least 65% when the target <i>f</i>T_>MIC of MEPM for treating <i>P. aeruginosa</i> bacteremia is defined as 75%.

Item Description

10.3390/antibiotics13030219
2079-6382