Optimization of Antimicrobial Administration in Elderly Patients with Melioidosis by Pharmacokinetic model combined with Monte Carlo simulation

OBJECTIVE To improve the medication regimen of antibiotics in elderly patients with melioidosis through pharmacokinetic model combined with Monte Carlo simulation. METHODS Based on the pharmacokinetic/pharmacodynamic model of meropenem, the Monte Carlo simulation was used to simulate the clinical drug use methods of various doses of meropenem, and the ideal drug delivery method was determined according to the simulation result. RESULTS The experimental data showed that the percentage of AUC_0-24/MIC>400 increased with the increase of meropenem dose. When the MIC value was 0.5 mg·L^-1 and the dosage of meropenem was 25 mg·kg^-1·d^-1, the proportion of AUC_0-24/MIC>400 was 99.43%. When the MIC value was 1 mg·L^-1 and the dose of meropenem was 35 mg·kg^-1·d^-1, the ratio of AUC_0-24/MIC>400 was 97.57%. When the MIC value was ≥ 2 mg·L^-1, the dose of meropenem could not meet the AUC_0-24/MIC>400 standard. CONCLUSION When the MIC reaches 0.5 mg·L^-1, the dosage of meropenem for clinical use should >25 mg·kg^-1·d^-1, while when the MIC reaches 1 mg·L^-1, the dosage of meropenem should be >35 mg·kg^-1·d^-1.