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Table 2 Probability of target attainment of selected ciprofloxacin and levofloxacin dosing regimens for Gram-negative infection with P. aeruginosa a in 5000 virtual patients with 8-h hemodialysis PIRRT at dialysate flow rate of 5 L/h during the initial 72 h

From: In silico trials using Monte Carlo simulation to evaluate ciprofloxacin and levofloxacin dosing in critically ill patients receiving prolonged intermittent renal replacement therapy

Dosing regimens Early PIRRTb Late PIRRTc
Day 1 PTA (%) Day 2 PTA (%) Day 3 PTA (%) Mean PTA (%) Day 1 PTA (%) Day 2 PTA (%) Day 3 PTA (%) Mean PTA (%)
Ciprofloxacin
200 mg q12h 0.0 0.0 0.0 0.0 0.0 0.3 0.6 0.1
400 mg q12h 3.9 24.3 33.4 17.3 7.8 30.0 38.0 23.8
800 mg q12h 66.6 91.2 92.5 87.9 72.5 92.6 93.7 90.1
200 mg q8h 0.3 5.8 11.2 3.5 0.4 5.5 10.5 3.5
400 mg q8h 27.7 71.0 76.2 62.2 30.1 70.3 75.6 63.3
600 mg q8h 75.4 96.1 96.9 93.9 76.3 96.2 96.9 94.3
1200 mg LD, then 800 mg q12h 89.9 92.3 92.7 92.9 93.1 94.2 94.4 94.8
Levofloxacin  
750 mg q24h 1.7 25.4 45.9 24.4 9.9 43.5 63.5 39.0
750 mg LD, then 250 mg q24h post-PIRRT 11.1 3.6 1.7 5.5 10.0 3.1 1.6 4.9
750 mg LD, then 500 mg q24h post-PIRRT 27.4 32.0 35.0 31.5 10.4 20.8 28.6 20.0
750 mg LD, then 750 mg q24h post-PIRRT 45.3 65.5 73.9 61.5 10.9 44.1 63.1 39.4
1500 mg LD, then 750 mg q24h post-PIRRT 83.7 84.2 83.4 83.8 66.3 74.1 77.6 72.7
1500 mg LD, then
1000 mg q24h post-PIRRT
89.2 93.8 95.3 92.8 67.2 84.8 91.4 81.2
2000 mg LD, then 1000 mg q24h post-PIRRT 96.4 97.1 96.9 96.8 87.5 92.5 94.5 91.5
  1. Bolded dosing regimens are the ones that attained PTA of ~90 % or greater in both early and late PIRRT, using the smallest daily dose
  2. LD loading dose
  3. aPharmacodynamic target used for Gram-negative infection was AUC24h:MIC ≥125 with MIC = 1 mg/L for ciprofloxacin and MIC = 2 mg/L for levofloxacin (susceptibility breakpoint for Pseudomonas aeruginosa)
  4. bEarly PIRRT: when the first fluoroquinolone dose is administered with the commencement of a daily PIRRT session
  5. cLate PIRRT: when the first fluoroquinolone dose is administered 16 h before a daily PIRRT session