Precision dosing software to optimize antimicrobial dosing: a systematic search and follow-up survey of available programs.

Anti-Bacterial Agents Anti-Infective Agents Bayes Theorem Follow-Up Studies Humans Software beta-Lactams
Antibiotics Antimicrobials Bayesian forecasting Beta-lactam antibiotics Dosing software Model informed precision dosing Therapeutic drug monitoring

Journal

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
ISSN: 1469-0691
Titre abrégé: Clin Microbiol Infect
Pays: England
ID NLM: 9516420

Informations de publication

Date de publication:
Sep 2022
Historique:
received: 23 12 2021
revised: 04 03 2022
accepted: 31 03 2022
pubmed: 17 4 2022
medline: 20 9 2022
entrez: 16 4 2022
Statut: ppublish

Résumé

Precision dosing programs are promising tools for optimising antimicrobial dosing. Selecting the ideal program for local application may be challenging due to the large variety of available programs with differing characteristics. The objectives of this study were to systematically identify available precision dosing software programs to optimize antimicrobial dosing and describe the characteristics of each program. Details on the ability of programs to provide beta-lactam dosing support was also gathered. A systematic review search strategy was used to identify candidate software programs described in the literature in Embase and PubMed. A detailed survey was then developed to identify characteristics of programs, including details on the underlying methodology driving dosing software recommendations, interface characteristics, costs and regulatory affairs. Software developers from all identified programs were invited to participate in the survey. The systematic search results identified 18 programs. Fifteen developers responded to the survey (83%) and 11 programs provide dosing support for at least one beta-lactam. Fourteen programs can utilize measured drug concentrations to generate dosing recommendations, with 13 able to generate empiric dosing recommendations. Six programs integrate with local electronic health records and four are registered with at least one regulatory agency. Pharmacokinetic models in combination with Bayesian statistics is the most common methodology used to generate dosing recommendations, with 14 programs utilizing this method. There was significant variability in the available antimicrobial profiles and characteristics among dosing software programs. As healthcare providers will differ in their requirements within their local settings, clinicians should use these findings to identify potential candidate programs and, if feasible, trial these to ensure they meet their specific requirements.

Sections du résumé

BACKGROUND BACKGROUND
Precision dosing programs are promising tools for optimising antimicrobial dosing. Selecting the ideal program for local application may be challenging due to the large variety of available programs with differing characteristics.
OBJECTIVES OBJECTIVE
The objectives of this study were to systematically identify available precision dosing software programs to optimize antimicrobial dosing and describe the characteristics of each program. Details on the ability of programs to provide beta-lactam dosing support was also gathered.
SOURCES METHODS
A systematic review search strategy was used to identify candidate software programs described in the literature in Embase and PubMed. A detailed survey was then developed to identify characteristics of programs, including details on the underlying methodology driving dosing software recommendations, interface characteristics, costs and regulatory affairs. Software developers from all identified programs were invited to participate in the survey.
CONTENT BACKGROUND
The systematic search results identified 18 programs. Fifteen developers responded to the survey (83%) and 11 programs provide dosing support for at least one beta-lactam. Fourteen programs can utilize measured drug concentrations to generate dosing recommendations, with 13 able to generate empiric dosing recommendations. Six programs integrate with local electronic health records and four are registered with at least one regulatory agency. Pharmacokinetic models in combination with Bayesian statistics is the most common methodology used to generate dosing recommendations, with 14 programs utilizing this method.
IMPLICATIONS CONCLUSIONS
There was significant variability in the available antimicrobial profiles and characteristics among dosing software programs. As healthcare providers will differ in their requirements within their local settings, clinicians should use these findings to identify potential candidate programs and, if feasible, trial these to ensure they meet their specific requirements.

Identifiants

DOI: 10.1016/j.cmi.2022.03.041 PMID: 35429656
pubmed: 35429656
pii: S1198-743X(22)00208-7
doi: 10.1016/j.cmi.2022.03.041
pii:
doi:

Substances chimiques

Anti-Bacterial Agents 0
Anti-Infective Agents 0
beta-Lactams 0

Types de publication

Journal Article Review Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

1211-1224

Informations de copyright

Copyright © 2022 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Auteurs

Nynke G L Jager (NGL)

Department of Pharmacy, Radboud University Medical Centre and Radboud Institute for Health Sciences, Nijmegen, the Netherlands.

Ming G Chai (MG)

Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia; Pharmacy Department, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia. Electronic address: g.chai@uq.net.au.

Reiner M van Hest (RM)

Department of Hospital Pharmacy - Clinical Pharmacology Unit, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.

Jeffrey Lipman (J)

Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia; Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Brisbane, QLD, Australia; Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Brisbane, QLD, Australia.

Jason A Roberts (JA)

Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia; Pharmacy Department, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Brisbane, QLD, Australia; Division of Anaesthesiology Critical Care Emergency and Pain Medicine, Nimes University Hospital, University of Montpellier, Nimes, France.

Menino O Cotta (MO)

Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.

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Classifications MeSH

questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Anti-infectieux › Antibactériens › Precision dosing software to optimize...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Anti-infectieux › Precision dosing software to optimize...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Probabilité › Théorème de Bayes › Precision dosing software to optimize...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études de suivi › Precision dosing software to optimize...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Precision dosing software to optimize...
questionsmedicales.fr › Sciences de l'information › Méthodologies informatiques › Logiciel › Precision dosing software to optimize...
questionsmedicales.fr › Composés hétérocycliques › Composés hétérocycliques à cycles fusionnés › Composés hétérobicycliques › bêta-Lactames › Precision dosing software to optimize...