ArticleThe Journal of antimicrobial chemotherapy2025
Individualization of piperacillin dosage based on therapeutic drug monitoring with or without model-informed precision dosing: a scenario analysis.
Article in The Journal of antimicrobial chemotherapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Towards Model-Informed Precision Dosing of High-Dose Rifampicin: A Parsimonious Population Pharmacokinetic Model Capturing Saturation and Autoinduction in Tanzanian and South African Patients with Tuberculosis.Clinical pharmacokinetics · 2026Article
- Article
- Optimizing imatinib sampling strategies through a population approach: a crucial step to model-informed precision dosing validation for point-of-care therapeutic drug monitoring.BMC pharmacology & toxicology · 2026Article
- Population Pharmacokinetic Modelling of Unbound Mycophenolic Acid and its Glucuronide in Adult Kidney Transplant Recipients in Early Post-Transplant.Clinical pharmacokinetics · 2026Observational
- Bayesian Dosing Simulator (BDS): A Pharmacokinetic Modeling Tool for Optimized Antibiotic Therapy.Pharmacotherapy · 2026Article
- Uncertainty undermines the validity of antimicrobial pharmacodynamics.Journal of pharmacokinetics and pharmacodynamics · 2026Article
- Therapeutic Drug Monitoring and Point-of-Care Technologies: Opportunities and Current Challenges.Therapeutic drug monitoring · 2026Review
- Can Model-Informed Precision Dosing of Beta-Lactams in Critical Care Improve Clinical Outcomes?Chemotherapy · 2026Review
- Guidance for External Evaluation and Selection of Population Pharmacokinetic Models for Precision Dosing.Clinical pharmacokinetics · 2026Review
- Piperacillin-tazobactam caused post-trauma patient's postoperative leukopenia, hypokalemia, and periodic fever: a case report.International journal of emergency medicine · 2025Article
- Numerical Verification of Tucuxi, a Promising Bayesian Adaptation Tool for Model-Informed Precision Dosing.CPT: pharmacometrics & systems pharmacology · 2025Article
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11 authors.
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Abstract
backgroundModel-informed precision dosing (MIPD) combines population pharmacokinetic knowledge with therapeutic drug monitoring (TDM) to optimize dosage adjustment. It could improve target concentration attainment over empirical TDM, still widely practised for broad-spectrum antibiotics.
objectivesTo evaluate the respective performance of TDM and MIPD in achieving target piperacillin exposure.
methodsMeasurements from 80 courses of intermittent piperacillin infusions, each with two TDM samples, were retrospectively submitted to our MIPD software TUCUXI. We considered six dosage adjustment strategies: identical dosage for all (4000 mg q8h), actual initial dosage (chart-based), actual empirical adjustment following first TDM, a priori MIPD-based dosage, a posteriori MIPD-based adjustment after first TDM and MIPD including both TDM measurements. Dosing strategies were compared regarding daily dosage, trough levels distribution and PTA (with target trough 8-32 mg/L).
resultsMedian trough concentration fell within 8-32 mg/L for all strategies except a priori MIPD-based dosage (42 mg/L). Distributions of trough concentrations predicted with the six dosage adjustment strategies showed significant differences, with both a posteriori MIPD-based strategies best reducing their standard deviation (P < 0.001). PTA of 32%, 32%, 55%, 29%, 83% and 94% were estimated, respectively for the six strategies (P < 0.001). Poor performance of a priori MIPD-based dosage did not hinder a posteriori MIPD-based strategies from significantly improving target attainment.
conclusionsWhilst empirical TDM improves exposure standardization and target attainment compared with no TDM, MIPD can still bring further improvement. Prospective trials remain warranted to confirm MIPD benefits not only on target attainment but also on clinical endpoints.
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