Search

Your search keyword '"Cui-Fang Wu"' showing total 2 results
Start Over Author "Cui-Fang Wu" Topic population pharmacokinetics
2 results on '"Cui-Fang Wu"'

1. Population pharmacokinetics of intravenous colistin sulfate and dosage optimization in critically ill patients

Author

Yue-liang Xie, Xin Jin, Shan-shan Yan, Cui-fang Wu, Bi-xiao Xiang, Hui Wang, Wu Liang, Bing-chang Yang, Xue-fei Xiao, Zhi-ling Li, Qi Pei, Xiao-cong Zuo, and Yue Peng

Subjects
colistin sulfate, population pharmacokinetics, urinary recovery, dosing regimens, critically ill patients, Therapeutics. Pharmacology, RM1-950
Abstract

Aims: To explore the population pharmacokinetics of colistin sulfate and to optimize the dosing strategy for critically ill patients.Methods: The study enrolled critically ill adult patients who received colistin sulfate intravenously for more than 72 h with at least one measurement of plasma concentration. Colistin concentrations in plasma or urine samples were measured by ultraperformance liquid chromatography tandem mass spectrometry (LC-MS/MS). The population pharmacokinetics (PPK) model for colistin sulfate was developed using the Phoenix NLME program. Monte Carlo simulation was conducted to evaluate the probability of target attainment (PTA) for optimizing dosing regimens.Results: A total of 98 plasma concentrations from 20 patients were recorded for PPK modeling. The data were adequately described by a two-compartment model with linear elimination. During modeling, creatinine clearance (CrCL) and alanine aminotransferase (ALT) were identified as covariates of the clearance (CL) and volume of peripheral compartment distribution (V2), respectively. In addition, colistin sulfate was predominantly cleared by the nonrenal pathway with a median urinary recovery of 10.05% with large inter-individual variability. Monte Carlo simulations revealed a greater creatinine clearance associated with a higher risk of sub-therapeutic exposure to colistin sulfate. The target PTA (≥90%) of dosage regimens recommended by the label sheet was achievable only in patients infected by pathogens with MIC ≤0.5 mg/L or with renal impairments.Conclusion: Our study showed that the dose of intravenous colistin sulfate was best adjusted by CrCL and ALT. Importantly, the recommended dosing regimen of 1.0–1.5 million units daily was insufficient for patients with normal renal functions (CrCL ≥80 ml/min) or those infected by pathogens with MIC ≥1.0 mg/L. The dosage of colistin sulfate should be adjusted according to renal function and drug exposure.

Published
2022
Full Text
View/download PDF

2. External evaluation of published population pharmacokinetic models of polymyxin B

Author

Jun-Jie Ding, Ya-Qian Li, Jing-Jing Liu, Guoping Yang, Hongyi Tan, Nan Yang, Kai-Feng Chen, Cui-Fang Wu, Yue-Liang Xie, Qi Pei, and Ya-Qi Lin

Subjects
Pharmacology, education.field_of_study, Computer science, Mean squared prediction error, Bayesian probability, Population, Bayes Theorem, General Medicine, Population pharmacokinetics, Models, Biological, Pharmacokinetics, Statistics, Prior probability, medicine, Humans, Pharmacology (medical), Predictability, education, Immunosuppressive Agents, Polymyxin B, medicine.drug
Abstract

Several population pharmacokinetics (popPK) models for polymyxin B have been constructed to optimize therapeutic regimens. However, their predictive performance remains unclear when extrapolated to different clinical centers. Therefore, this study aimed to evaluate the predictive ability of polymyxin B popPK models. A literature search was conducted, and the predictive performance was determined for each selected model using an independent dataset of 20 patients (92 concentrations) from the Third Xiangya Hospital. Prediction- and simulation-based diagnostics were used to evaluate model predictability. The influence of prior information was assessed using Bayesian forecasting. Eight published studies were evaluated. In prediction-based diagnostics, the prediction error within ± 30% was over 50% in two models. In simulation-based diagnostics, the prediction- and variability-corrected visual predictive check (pvcVPC) showed satisfactory predictivity in three models, while the normalized prediction distribution error (NPDE) tests indicated model misspecification in all models. Bayesian forecasting demonstrated a substantially improvement in the model predictability even with one prior observation. Not all published models were satisfactory in prediction- and simulation-based diagnostics; however, Bayesian forecasting improved the predictability considerably with priors, which can be applied to guide polymyxin B dosing recommendations and adjustments for clinicians.

Published
2021

Catalog

Books, media, physical & digital resources
See catalog results