Optimization of antimicrobial therapy based on integrated quantitative evaluation of physiological pharmacokinetics, disease pharmacodynamics and drug-resistance mechanisms

2021 Fiscal Year Final Research Report

• Project/Area Number: 19K07221
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 47060:Clinical pharmacy-related
• Research Institution: Hiroshima University
• Principal Investigator: Ikawa Kazuro 広島大学, 医系科学研究科(薬), 准教授 (40363048)
• Co-Investigator(Kenkyū-buntansha): 森川 則文 広島大学, 医系科学研究科(薬), 教授 (30346481) ; 大毛 宏喜 広島大学, 病院(医), 教授 (70379874)
• Project Period (FY): 2019-04-01 – 2022-03-31
• Keywords: 臨床 / 感染症 / 薬物動態 / 薬力学

Outline of Final Research Achievements

This research project aimed to quantitatively evaluate relation and interaction among physiological pharmacokinetics of drugs, disease pharmacodynamics of host patients, and drug-resistance mechanisms of causative organisms, in order to optimize antimicrobial therapy. The research monitored concentrations of drugs, such as beta-lactams, quinolones, macrolides, imidazoles, anti-resistant-bacteria drugs, antifungals, and antivirals in plasma, peritoneal fluid, peritoneum, prostate and epididymis tissues. Being integrated with various minimum inhibitory concentration, pharmacodynamic time-killing and clinical data, these pharmacokinetic data were used for population modeling and simulation. Based on the relation and interaction among drug, host and organism, computer tools were created, applied to patients for optimizing antimicrobial therapy, and assessed with their feedback information.

Free Research Field

臨床薬理学

Academic Significance and Societal Importance of the Research Achievements

本研究の特色は日々の感染症治療に直結している点にあり、本研究の学術的および社会的な意義・価値は、感染症（国民の死因原因の上位）に対する治療効果を最大化することで医療の質および医療経済の向上に貢献する点にある。そして、生理学的PK/病態時PDと薬剤耐性機構の統合的な定量解析評価に基づいた個別最適化抗菌薬療法アルゴリズムの提案は、斬新で独創的なアプローチである。最適投与法を確立し個別化医療を実現することにより、治療上の利益を患者に直接還元することが、本研究の成果として評価できる。