Population Pharmacokinetics with Monte Carlo Simulations of Gentamicin in a Population of Severely Ill Adult Patients from Sub-Saharan Africa

Antimicrob Agents Chemother. 2019 Mar 27;63(4):e02328-18. doi: 10.1128/AAC.02328-18. Print 2019 Apr.

Abstract

In sub-Saharan Africa (SSA), gentamicin is commonly used for severe infections in non-intensive-care-unit (ICU) settings, but pharmacokinetic and pharmacodynamic data for this specific population are lacking. We performed a population pharmacokinetic study in an adult Mozambican non-ICU hospital population treated with gentamicin (n = 48) and developed a pharmacokinetic model using nonlinear mixed-effects modeling. Simulations showed that non-ICU patient populations in SSA may be at substantial risk for underexposure to gentamicin during routine once-daily dosing.

Keywords: aminoglycosides; gentamicin; pharmacodynamics; population pharmacokinetics; severe illness; sub-Saharan Africa.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Africa South of the Sahara
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / pharmacokinetics*
  • Critical Illness
  • Female
  • Gentamicins / pharmacokinetics*
  • Humans
  • Intensive Care Units
  • Male
  • Microbial Sensitivity Tests / methods
  • Middle Aged
  • Models, Biological
  • Monte Carlo Method
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Gentamicins