Table 2.
Probability of pharmacokinetic/pharmacodynamic target (fT > MIC ≥ 35%) attainment by CVVH flow rate in acute kidney impairment subjects with residual kidney function (250 mg q12h, 4-hour infusion).
| MIC (mg/L) | CVVH flow rate (L/hr) | |||
|---|---|---|---|---|
| 0.5 | 1 | 2 | 3 | |
| 1 | 0.984 | 0.981 | 0.973 | 0.963 |
| 2 | 0.603 | 0.573 | 0.514 | 0.455 |
| 4 | 0.021 | 0.017 | 0.012 | 0.008 |
| 8 | 0.000 | 0.000 | 0.000 | 0.000 |
Pharmacokinetic-pharmacodynamic target attainment probabilities for CVVH are based on a simulation of 5000 subjects using mean pharmacokinetic parameter estimates [14], with inflated between-subject variability (40% CV) and assuming a protein binding of 8.5% along with the presence of residual kidney function. Total drug CL represented a sum of 2 × CLNR, renal CL, and CVVH CL. The renal component of the clearance allowed residual kidney function with a CrCL of 30 mL/min.