Publications by authors named "P A de Cock"
Background: AUC-based dosing with validated Bayesian software is recommended as a good approach to guide bedside vancomycin dosing.
Objectives: To compare treatment and vancomycin-associated acute kidney injury (AKI) costs between Bayesian AUC-based dosing and conventional therapeutic drug monitoring (TDM) using steady-state plasma concentrations of vancomycin administered as continuous infusion in hospitalized non-critically ill patients with severe Gram-positive infection.
Methods: A cost-benefit analysis presented as a return on investment (ROI) analysis from a hospital perspective was conducted using a decision tree model (TDM versus AUC-based dosing) to simulate treatment cost (personnel, serum sampling and drug cost), vancomycin-associated AKI risk and cost up to 14 days.
Background And Objectives: The pharmacokinetics (PK) of piperacillin/tazobactam (PIP/TAZ) is highly variable across different patient populations and there are controversies regarding non-linear elimination as well as the fraction unbound of PIP (f). This has led to a plethora of subgroup-specific models, increasing the risk of misusing published models when optimising dosing regimens. In this study, we aimed to develop a single model to simultaneously describe the PK of PIP/TAZ in diverse patient populations and evaluate the current dosing recommendations by predicting the PK/pharmacodynamics (PD) target attainment throughout life.
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- Vancomycin is an antibiotic used for serious Gram-positive infections in children, and its effectiveness depends on a specific dosing measurement known as the AUC/MIC ratio.
- The study compares a new model-informed precision dosing (MIPD) method with standard care in 14 pediatric clinical settings to see if MIPD improves dosing accuracy and reduces potential kidney damage.
- Key outcomes include the rate of patients achieving the target AUC/MIC within the first few days of treatment and monitoring the occurrence of acute kidney injury during this period.
A Pooled Population Pharmacokinetic Study of Oral and Intravenous Administration of Clavulanic Acid in Neonates and Infants: Targeting Effective Beta-Lactamase Inhibition.
Clin Pharmacol Ther
January 2025
Article Synopsis
- The study investigates the pharmacokinetics of oral clavulanic acid in neonates and infants, as existing data on this topic is limited.
- It analyzes combined data from four datasets using a one-compartment model to determine dosing regimens and exposure levels based on age and body weight.
- Findings indicate that an amoxicillin/clavulanic acid ratio of 4:1 is optimal, with significant differences in exposure levels based on varying threshold concentrations, laying groundwork for future research.
Introduction: β-Lactams are the most widely used antibiotics in children. Their optimal dosing is essential to maximize their efficacy, while minimizing the risk for toxicity and the further emergence of antimicrobial resistance. However, most β-lactams were developed and licensed long before regulatory changes mandated pharmacokinetic studies in children.
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