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Indian Journal of Pharmaceutical Education and ResearchNOW IN
Article

Estimation of the Probability to Target Attainment to the Pharmacokinetic/ Pharmacodynamic Index of Ertapenem in Elderly Inpatients

Daniel Palma1★, Elena Vega2, María Gai2★ Corresponding author

  1. 1Department of Internal Medicine, University of Chile´s Clinical Hospital, Santiago, CHILE.
  2. 2Department of Pharmaceutical Science and Technology, Faculty of Chemistry and Pharmaceutical Sciences, University of Chile, Santiago, CHILE.

CORRESPONDENCE

Daniel Palma

Department of Internal Medicine, University of Chile´s Clinical Hospital, Santiago, CHILE.

dpalma@hcuch.cl

Received: 11-02-2020; Revised: 08-06-2020; Accepted: 09-09-2020.

Volume 54, Issue 4 · pp. 1180–1183 · PUBLISHED 2020 · DOI: 10.5530/ijper.54.4.215

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ABSTRACT

Background: Infectious diseases are one of the most causes of hospitalization and death in adults in the elderly and this population is prone to develop complications and pharmacokinetic/pharmacodynamic changes. Objectives: To estimate the probability to target attainment (PTA) to the pharmacokinetic/pharmacodynamic (PK/ PD) index of ertapenem for older adults hospitalized in a medical ward. Materials and Methods: In a prospective and observational analysis, free drug concentrations of ertapenem were determined in older adults hospitalized at medical ward setting and compared with EUCAST epidemiological cut-off values (ECOFF: 0.064 mg/L) to extreme MIC (64 mg/L), using 1000 Monte Carlo simulations to estimate therapeutic target attainment (%f T ≥ MIC ≥ 40%). Results: Five elderly inpatients with renal impairment and hypoalbuminemia were included with eight samples per patient (n=40 observations). Monte Carlo simulations shown free ertapenem concentrations attain to PK/PD index on the MIC interval from 0.064 to 4 mg/L. Conclusion: If pathogen MICs are ≥ 4 mg/L, elderly inpatients could not attain to the PK/PD target of ertapenem in medical ward setting, rising probability of antimicrobial resistance and therapeutic failure in this population.

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    Palma, D., Vega, E., & Gai, M. (2020). Estimation of the Probability to Target Attainment to the Pharmacokinetic/ Pharmacodynamic Index of Ertapenem in Elderly Inpatients. Indian Journal of Pharmaceutical Education and Research, 54(4), 1180–1183. https://doi.org/10.5530/ijper.54.4.215