Modeling of pharmacokinetic/pharmacodynamic parameters in regular intermittent intravenous infusion and translational application of the models in personalized antibiotics dosing

Abstract Objective Quantitative calculation models for the ratio of daily area under the concentration–time curve (AUC24) to the minimum inhibitory concentration (MIC) (i.e., AUC24/MIC) and the amount of time that concentration stays above the MIC during a dosing interval (i.e., T>MIC%) in regula...

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Main Author: Xiangqing Song
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Journal of Translational Medicine
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Online Access:https://doi.org/10.1186/s12967-025-06832-5
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author Xiangqing Song
author_facet Xiangqing Song
author_sort Xiangqing Song
collection DOAJ
description Abstract Objective Quantitative calculation models for the ratio of daily area under the concentration–time curve (AUC24) to the minimum inhibitory concentration (MIC) (i.e., AUC24/MIC) and the amount of time that concentration stays above the MIC during a dosing interval (i.e., T>MIC%) in regular intermittent i.v. infusion (RIIVI) are currently absent. This work set out to construct the models of AUC24/MIC, T>MIC% and matching daily dosage (Dd) in RIIVI, and further examine their performance by comparing with the documented models currently used widely, and concomitantly create a closed loop for evaluating the original scheme’s effectiveness and developing the personalized dosing regimen using these established models. Methods 1-compartment model was used to construct the AUC24/MIC, T>MIC% and matching Dd models. 20 designed individuals with different renal functions in different clinical scenarios were employed to examine the models. Bland–Altman plots and Bootstrap analysis were applied to assess the consistency, and the prediction reliability and accuracy of the models in calculating AUC24/MIC and T>MIC%, respectively. Tornado method based on global sensitivity analysis was used to perform the sensitivity analysis of the models to examine the effect of parameter variation on predictions. Combining the AUC24/MIC or T>MIC% model-based efficacy assessment with the Dd model-based regimen optimization to creates a closed loop consisting of efficacy assessment and regimen optimization. Results The AUC24/MIC, T>MIC% and Dd models in RIIVI were developed. Bland–Altman plots and Bootstrap analysis indicated that the established and the documented models had no consistency and the established models had better prediction reliability and accuracy in calculating AUC24/MIC and T>MIC%. Sensitivity analysis suggested that MIC was an important factor on AUC24/MIC and T>MIC% variation. Cooperative application of the AUC24/MIC, T>MIC% and Dd model created a closed loop consisting of efficacy assessment and regimen optimization for creation of customized antibiotic regimens. Conclusions The established AUC24/MIC and T>MIC% models displayed better performance relative to the documented models. Cooperative application of these models and the corresponding Dd model can create a fully closed loop for evaluating the original scheme’s effectiveness and developing the optimization regimen, and thus construct a basic framework for the creation of customized antibiotic regimens.
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spelling doaj-art-4b35c81200914b7f8eeaee81d24e7dd72025-08-20T03:46:27ZengBMCJournal of Translational Medicine1479-58762025-07-0123112210.1186/s12967-025-06832-5Modeling of pharmacokinetic/pharmacodynamic parameters in regular intermittent intravenous infusion and translational application of the models in personalized antibiotics dosingXiangqing Song0Department of Pharmacy, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South UniversityAbstract Objective Quantitative calculation models for the ratio of daily area under the concentration–time curve (AUC24) to the minimum inhibitory concentration (MIC) (i.e., AUC24/MIC) and the amount of time that concentration stays above the MIC during a dosing interval (i.e., T>MIC%) in regular intermittent i.v. infusion (RIIVI) are currently absent. This work set out to construct the models of AUC24/MIC, T>MIC% and matching daily dosage (Dd) in RIIVI, and further examine their performance by comparing with the documented models currently used widely, and concomitantly create a closed loop for evaluating the original scheme’s effectiveness and developing the personalized dosing regimen using these established models. Methods 1-compartment model was used to construct the AUC24/MIC, T>MIC% and matching Dd models. 20 designed individuals with different renal functions in different clinical scenarios were employed to examine the models. Bland–Altman plots and Bootstrap analysis were applied to assess the consistency, and the prediction reliability and accuracy of the models in calculating AUC24/MIC and T>MIC%, respectively. Tornado method based on global sensitivity analysis was used to perform the sensitivity analysis of the models to examine the effect of parameter variation on predictions. Combining the AUC24/MIC or T>MIC% model-based efficacy assessment with the Dd model-based regimen optimization to creates a closed loop consisting of efficacy assessment and regimen optimization. Results The AUC24/MIC, T>MIC% and Dd models in RIIVI were developed. Bland–Altman plots and Bootstrap analysis indicated that the established and the documented models had no consistency and the established models had better prediction reliability and accuracy in calculating AUC24/MIC and T>MIC%. Sensitivity analysis suggested that MIC was an important factor on AUC24/MIC and T>MIC% variation. Cooperative application of the AUC24/MIC, T>MIC% and Dd model created a closed loop consisting of efficacy assessment and regimen optimization for creation of customized antibiotic regimens. Conclusions The established AUC24/MIC and T>MIC% models displayed better performance relative to the documented models. Cooperative application of these models and the corresponding Dd model can create a fully closed loop for evaluating the original scheme’s effectiveness and developing the optimization regimen, and thus construct a basic framework for the creation of customized antibiotic regimens.https://doi.org/10.1186/s12967-025-06832-5Concentration-dependent antibioticsTime-dependent antibioticsMathematical modelingQuantitative modelsPharmacokinetic/pharmacodynamic
spellingShingle Xiangqing Song
Modeling of pharmacokinetic/pharmacodynamic parameters in regular intermittent intravenous infusion and translational application of the models in personalized antibiotics dosing
Journal of Translational Medicine
Concentration-dependent antibiotics
Time-dependent antibiotics
Mathematical modeling
Quantitative models
Pharmacokinetic/pharmacodynamic
title Modeling of pharmacokinetic/pharmacodynamic parameters in regular intermittent intravenous infusion and translational application of the models in personalized antibiotics dosing
title_full Modeling of pharmacokinetic/pharmacodynamic parameters in regular intermittent intravenous infusion and translational application of the models in personalized antibiotics dosing
title_fullStr Modeling of pharmacokinetic/pharmacodynamic parameters in regular intermittent intravenous infusion and translational application of the models in personalized antibiotics dosing
title_full_unstemmed Modeling of pharmacokinetic/pharmacodynamic parameters in regular intermittent intravenous infusion and translational application of the models in personalized antibiotics dosing
title_short Modeling of pharmacokinetic/pharmacodynamic parameters in regular intermittent intravenous infusion and translational application of the models in personalized antibiotics dosing
title_sort modeling of pharmacokinetic pharmacodynamic parameters in regular intermittent intravenous infusion and translational application of the models in personalized antibiotics dosing
topic Concentration-dependent antibiotics
Time-dependent antibiotics
Mathematical modeling
Quantitative models
Pharmacokinetic/pharmacodynamic
url https://doi.org/10.1186/s12967-025-06832-5
work_keys_str_mv AT xiangqingsong modelingofpharmacokineticpharmacodynamicparametersinregularintermittentintravenousinfusionandtranslationalapplicationofthemodelsinpersonalizedantibioticsdosing