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PK models for common antibiotics

Table 1. Pharmacokinetic parameters of common antibiotics
Derived model parameters Literature values
Drug Target peak Target trough KelNon-Renal KelRenal Vd L/kg Dose Interval Infusion Measured peak T 1/2 Norm T 1/2 ESRD
Ampicillin 50 5 0.058 0.0064 0.26 1 g 4 hr 30 min 58- 71 1- 1.2 7- 20
Aztreonam 100 10 0.116 0.0023 0.143 1 g 8 hr 30 min 164 1.5- 2 6- 8
Cefazolin 120 20 0.032 0.0026 0.15 1 g 8 hr 30 min 185 2 40- 70
Cefepime 85 6 0.0385 0.0026 0.17 1 g 8 hr 30 min 79- 82 2- 2.2 13.5- 19
Cefotaxime 80 4 0.069 0.0056 0.16 1 g 6 hr 30 min 40- 100 1- 1.4 10- 15
Cefoxitin 60 6 0.035 0.0066 0.216 1 g 6 hr 30 min 110 1 13- 23
Ceftazidime 60 6 0.028 0.0034 0.237 1 g 8 hr 30 min 70- 90 1.2 13- 25
Ceftizoxime 60 6 0.028 0.0046 0.229 1 g 8 hr 30 min 60- 87 1.4 35
Cefuroxime 60 8 0.041 0.0051 0.174 1.5 g 8 hr 30 min 100 1.2 17
Ciprofloxacin 7.5 1.2 0.10043 0.00138 0.82 400 mg 12 hr 60 min 6.8 4.2- 4.7 6.9- 13.8
Ertapenem 140 2 0.0495 0.00144 0.098 1 g 24 hr 30 min 90- 150 4 6- 14
Imipenem 40 1 0.173 0.0052 0.162 500 mg 6 hr 30 min 21- 58 1 4
Levofloxacin 7.3 1.0 0.00912 0.00072 1.07 500 mg 24 hr 60 min 6.4 6- 8 76
Meropenem 60 2 0.099 0.00385 0.213 1 g 8 hr 30 min 55 1 6.8- 13.7
Piperacillin 250 25 0.173 0.0052 0.156 4g 6 hr 30 min 244- 400 0.8- 1.5 3.3- 5.1

 

 

Model parameters on the left side of Table 1. were derived from the literature values listed on the right side of the table.

The pk model parameters were reconciled using the FreeKin Modeler.

As you can see from the table, some of the measured values reported in the literature vary widely.

Given the wide range in reported values, it is not possible to reconcile some of these antibiotics into one perfect model. You will need to modify them to best suit your needs.

 

How to download

These additionial models may be downloaded to our PK programs using the import tool on the drug model editor dialog.

Antibiotic Kinetics for Windows step-by-step:

  1. Click File ! Edit drug models on the main menu:
    Model editor menu

  2. Click the More button on the drug model editor dialog:
    More button

  3. Select from available models, click the left arrow button(s) to move to current models:
    Import dialog

  4. Click the Save button when selection complete.

 

Submit a model

Submit a model to share with your colleagues.

 

References

  1. Benz C, Brown CM. "Beta-Lactams" in Clinical Drug Data, 11th Ed. McGraw Hill Medical. 2010.
  2. Ritschel WA: Handbook of Basic Pharmacokinetics, 6th edition. Washington, DC. APhA, 2004.
  3. Aronoff George R, et al: Drug Prescribing in Renal Failure. Philadelphia, PA. ACP, 1999.
  4. Zaske D, Lesar T. "Other Anti-Infective Agents" in A Textbook for the Clinical Application of Therapeutic Drug Monitoring, Taylor and Caviness (Ed). Abbott Laboratories, Irving, TX. 1986.
  5. Shargel L, Yu Andrew. "Dosage Adjustment in Renal Disease" in Applied Biopharmaceutics and Pharmacokinetics. Norwalk, CT. Appleton-Century-Crofts. 1980.
  6. Nightingale CH, French MA, Quintiliani R. "Cephalosporins" in Applied Pharmacokinetics: Principles of Therapeutic Drug Monitoring, Evans, Schentag and Jusco (Ed). Applied Therapeutics. 1980.
  7. Package inserts for each drug.
  8. Mistry GC1, et al. Pharmacokinetics of ertapenem in patients with varying degrees of renal insufficiency and in patients on hemodialysis. J Clin Pharmacol. 2006 Oct;46(10):1128-38.
  9. Burkhardt, 0. Pharmacokinetics of ertapenem in critically ill patients with acute renal failure undergoing extended daily dialysis. Nephrol Dial Transplant (2009) 24: 267–271.
  10. M Chimata, M Nagase, et al. Pharmacokinetics of meropenem in patients with various degrees of renal function, including patients with end-stage renal disease. Antimicrob. Agents Chemother. 1993 Feb;37(2):229-233.
  11. Shah A1, et al. Pharmacokinetics of intravenous ciprofloxacin in normal and renally impaired subjects. J Antimicrob Chemother. 1996 Jul;38(1):103-16.
  12. G L Drusano, M Weir, et al. Pharmacokinetics of Intravenously Administered Ciprofloxacin in Patients with Various Degrees of Renal Function. Antimicrob. Agents Chemother. 1987 Jun;31(6):860-864.
  13. Rodvold K and Neuhauser M, Pharmacokinetics and Pharmacodynamics of Fluoroquinolones. Pharmacotherapy. 2001;21(10s).
  14. Dialyze-HD web site. A comprehensive literature review of pharmacokinetic studies of drug dialyzability. Accessed April 2014.

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