Evidence map›Paper›PMID 42057443›Full record

ArticlePharmacotherapy2026

Bayesian Dosing Simulator (BDS): A Pharmacokinetic Modeling Tool for Optimized Antibiotic Therapy.

Adrian Valadez, Marc H Scheetz, Michael N Neely, Helen K Donnelly, Erin Korth, Richard G Wunderink, Nathaniel J Rhodes

Erratum issuedAbstract read
In one paragraph

Article in Pharmacotherapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Adrian ValadezDepartment of Pharmacy Practice, Midwestern University, College of Pharmacy, Downers Grove, Illinois, USA.ORCID 0009-0003-4192-5229
Marc H ScheetzDepartment of Pharmacy Practice, Midwestern University, College of Pharmacy, Downers Grove, Illinois, USA.ORCID 0000-0002-1091-6130
Michael N NeelyKeck School of Medicine, University of Southern California, Los Angeles, California, USA.ORCID 0000-0002-1675-8276
Helen K DonnellyDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.ORCID 0000-0001-8827-8581
Erin KorthDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.ORCID 0000-0003-3853-3219
Richard G WunderinkDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.ORCID 0000-0002-8527-4195
Nathaniel J RhodesDepartment of Pharmacy Practice, Midwestern University, College of Pharmacy, Downers Grove, Illinois, USA.ORCID 0000-0002-0018-5434

Funding

Systems-based pharmacologic modelling to elucidate beta-lactam clinical pharmacodynamics and define optimal dosing regimens in severe pneumoniaR01AI158530 · NIAID · MIDWESTERN UNIVERSITY · PI Nathaniel James Rhodes · 2022 to 2026
$3.4M
Development and Evaluation of CRRT-Specific Precision Dosing Models to Optimize Beta-Lactam Treatment for Patients with Hospital-Acquired PneumoniaR21AI174159 · NIAID · MIDWESTERN UNIVERSITY · PI RHODES, NATHANIEL JAMES · 2023 to 2024
$417k
Midwestern UniversityNIAID NIH HHS R01 AI158530NIAID NIH HHS R21 AI174159NIH HHS
6 · The paper itself

Abstract

backgroundMeropenem is widely used to treat hospital-acquired pneumonia in critically ill patients, with efficacy dependent on the time that free concentrations exceed the minimum inhibitory concentration (fT > MIC). In practice, single-sample therapeutic drug monitoring (TDM) may not ensure target attainment, particularly in patients requiring continuous renal replacement (CRRT). Model-informed precision dosing (MIPD) enables individualized, real-time adjustments, but implementation is limited. Herein, we developed a Shiny application for Bayesian meropenem dose optimization.

methodsA previously published nonparametric model was translated into a parametric Bayesian framework with maximum a posteriori (MAP) updating implemented through a Shiny interface. Plasma pharmacokinetic (PK) data from critically ill patients served for external validation. Posterior predictions were benchmarked against population and individual (MAP) outputs from Pmetrics 3.09 and population median profiles from 1000 Monte Carlo simulations per patient. Predictive performance was assessed using relative median prediction error (rMPE) and relative median absolute prediction error (rMAPE), for the combined cohort overall and stratified by CRRT status. Sparse sampling scenarios (one, two, and three observations per patient) were also evaluated.

resultsEighteen patients were evaluated (non-CRRT n = 13; CRRT n = 5). In Pmetrics, rMPE ranged from -7.7% to 9.4% and rMAPE from 18.5% to 25.5% across renal replacement strata and prediction types. Simulation-based population predictions yielded greater error, with rMPE/rMAPE of -25%/34% in CRRT patients and -21%/30% in non-CRRT patients. Across Bayesian Dosing Simulator (BDS) sampling scenarios, prediction error remained within prespecified limits (rMPE ±20%, rMAPE ≤ 30%), with F20 ranging from 80% to 94% and F30 from 87% to 94%.

conclusionA validated nonparametric meropenem model was successfully implemented within an open-source Bayesian framework yielding predictive accuracy comparable to the reference model with robust performance under sparse sampling, supporting its feasibility for individualized meropenem dosing. Prospective evaluation of its clinical safety and effectiveness is needed.

Indexed as

Anti-Bacterial AgentsMeropenemModels, BiologicalBayes TheoremComputer SimulationContinuous Renal Replacement TherapyCritical IllnessDose-Response Relationship, DrugDrug MonitoringHumansMicrobial Sensitivity TestsMonte Carlo MethodAnti-Bacterial AgentsMeropenemBayesian modelmodel‐informed precision dosingpopulation PKshiny

Identifiers

PMID42057443
PMCPMC13224952

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.