Simplified Aztreonam Dosing in Patients with End-Stage Renal Disease: Results of a Monte Carlo Simulation

Antimicrob Agents Chemother. 2018 Oct 24;62(11):e01066-18. doi: 10.1128/AAC.01066-18. Print 2018 Nov.

Abstract

The manufacturer-recommended aztreonam dosing for patients with creatinine clearance values of <10 ml/min/1.73 m2 is complex. It is not known whether simpler posthemodialysis dosing administered once daily or thrice weekly can reliably achieve pharmacodynamic goals. We found that 1 or 2 g administered once daily after hemodialysis had >90% probability of target attainment up to MICs of 4 or 8 mg/liter, respectively. Thrice-weekly dosing should generally be avoided, except in nonsevere infections with MICs of ≤0.5 mg/liter.

Keywords: Monte Carlo simulation; aztreonam; end-stage renal disease; kidney dysfunction; pharmacodynamics; renal failure.

MeSH terms

  • Anti-Bacterial Agents / administration & dosage*
  • Aztreonam / administration & dosage*
  • Humans
  • Kidney Failure, Chronic / drug therapy*
  • Male
  • Monte Carlo Method
  • Probability
  • Renal Dialysis / methods

Substances

  • Anti-Bacterial Agents
  • Aztreonam