Publication details
Sub-populačně specifické farmakokinetické modely antibiotik – zaměřeno na pacienty s cystickou fibrózou
| Title in English | Subpopulation specific antibiotic pharmacokinetic models - aim for cystic fibrosis patients |
|---|---|
| Authors | |
| Year of publication | 2024 |
| Type | Conference abstract |
| MU Faculty or unit | |
| Citation | |
| Description | Infectious exacerbations of cystic fibrosis (CF) are conditions that are potentially life-threatening for patients. The basis of treatment is combined antibiotic therapy. Given the changes in pharmacokinetic parameters due to the underlying disease and poorer lung permeability in patients with CF, we choose higher antibiotic dosages. With the increasingly widespread use of therapeutic monitoring, it is becoming clear that even with higher doses of antibiotics recommended for this population, the PK/PD goal of treatment may not be achieved. These findings support the routine use of TDM antibiotics, for the optimal use of which the creation of CF-population-specific pharmacokinetic models is essential. A search was conducted on the given issue, and current literature describes changes in pharmacokinetic parameters of given antibiotics in the CF population. Aminoglycosides (gentamicin, amikacin) have a larger volume of distribution in the CF population when taking into account nutritional status and faster clearance. The data for changes in pharmacokinetic parameters of piperacillin and meropenem are not clear, however, most studies agree on faster renal clearance; In addition, nonlinear kinetics are described for piperacillin (especially when administered in continuous infusion). The high interindividual variability of vancomycin complicates the clear definition of differences between the general and CF populations; in some studies, faster elimination is described. These changes were reflected in existing population pharmacokinetic models (amikacin, gentamicin, meropenem, piperacillin and vancomycin - MWPharm a.s. models) so that they correspond as closely as possible to the population of patients with CF. Given the significant and relatively well-described changes in pharmacokinetic parameters in the CF population, the modification of pharmacokinetic models specifically for these patients is very beneficial for the use of TDM antibiotics in clinical practice. The creation of modified models for the CF population is the initial phase of the project aimed at the possibility of their validation for the given population. In the next step, their reliability for predicting the development of plasma levels of individual drugs in specific patients will be verified. |
| Related projects: |