dc.contributor.author
Liebchen, Uwe
dc.contributor.author
Klose, Marian
dc.contributor.author
Paal, Michael
dc.contributor.author
Vogeser, Michael
dc.contributor.author
Zoller, Michael
dc.contributor.author
Schroeder, Ines
dc.contributor.author
Schmitt, Lisa
dc.contributor.author
Huisinga, Wilhelm
dc.contributor.author
Michelet, Robin
dc.contributor.author
Zander, Johannes
dc.contributor.author
Scharf, Christina
dc.contributor.author
Weinelt, Ferdinand A.
dc.contributor.author
Kloft, Charlotte
dc.date.accessioned
2021-11-11T11:14:56Z
dc.date.available
2021-11-11T11:14:56Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/30592
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-30332
dc.description.abstract
Background: The MeroRisk-calculator, an easy-to-use tool to determine the risk of meropenem target non-attainment after standard dosing (1000 mg; q8h), uses a patient’s creatinine clearance and the minimum inhibitory concentration (MIC) of the pathogen. In clinical practice, however, the MIC is rarely available. The objectives were to evaluate the MeroRisk-calculator and to extend risk assessment by including general pathogen sensitivity data. Methods: Using a clinical routine dataset (155 patients, 891 samples), a direct data-based evaluation was not feasible. Thus, in step 1, the performance of a pharmacokinetic model was determined for predicting the measured concentrations. In step 2, the PK model was used for a model-based evaluation of the MeroRisk-calculator: risk of target non-attainment was calculated using the PK model and agreement with the MeroRisk-calculator was determined by a visual and statistical (Lin’s concordance correlation coefficient (CCC)) analysis for MIC values 0.125–16 mg/L. The MeroRisk-calculator was extended to include risk assessment based on EUCAST-MIC distributions and cumulative-fraction-of-response analysis. Results: Step 1 showed a negligible bias of the PK model to underpredict concentrations (−0.84 mg/L). Step 2 revealed a high level of agreement between risk of target non-attainment predictions for creatinine clearances >50 mL/min (CCC = 0.990), but considerable deviations for patients <50 mL/min. For 27% of EUCAST-listed pathogens the median cumulative-fraction-of-response for the observed patients receiving standard dosing was < 90%. Conclusions: The MeroRisk-calculator was successfully evaluated: For patients with maintained renal function it allows a reliable and user-friendly risk assessment. The integration of pathogen-based risk assessment substantially increases the applicability of the tool.
en
dc.format.extent
13 Seiten
dc.rights.uri
https://creativecommons.org/licenses/by/4.0/
dc.subject
risk assessment
en
dc.subject
individualized dosing
en
dc.subject
model-based evaluation
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::616 Krankheiten
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::615 Pharmakologie, Therapeutik
dc.title
Evaluation of the MeroRisk Calculator, A User-Friendly Tool to Predict the Risk of Meropenem Target Non-Attainment in Critically Ill Patients
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.articlenumber
468
dcterms.bibliographicCitation.doi
10.3390/antibiotics10040468
dcterms.bibliographicCitation.journaltitle
Antibiotics
dcterms.bibliographicCitation.number
4
dcterms.bibliographicCitation.originalpublishername
MDPI
dcterms.bibliographicCitation.volume
10
dcterms.bibliographicCitation.url
https://doi.org/10.3390/antibiotics10040468
refubium.affiliation
Biologie, Chemie, Pharmazie
refubium.affiliation.other
Institut für Pharmazie
refubium.note.author
Die Publikation wurde aus Open Access Publikationsgeldern der Freien Universität Berlin gefördert.
de
refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dcterms.isPartOf.eissn
2079-6382