Observational Study
Copyright ©The Author(s) 2025.
World J Clin Cases. Jun 6, 2025; 13(16): 102866
Published online Jun 6, 2025. doi: 10.12998/wjcc.v13.i16.102866
Table 1 Effect of pharmacokinetic indices on efficacy
Characteristics
Ineffective (n = 26)
Effective (n = 77)
P value
Mean daily dose (g)1.7 ± 0.51.8± 0.50.4689
Cmin (μg/mL)6.9 ± 3.314.5 ± 6.2< 0.0001
AUC0-24342.8 ± 119.1546.8 ± 171.8< 0.0001
AUC0-24/MIC467.0 ± 248.1696.2 ± 327.10.0015
AUC: Area under the curve; Cmin: Trough concentration; MIC: Minimum inhibitory concentration.
Table 2 Effect of pharmacokinetic indices on nephrotoxicity
Characteristics
Non-nephrotoxic (n = 76)
Nephrotoxic (n = 27)
P value
Mean daily dose (g)1.7 ± 0.51.9 ± 0.40.1371
Cmin (μg/mL)12.4 ± 6.313.3 ± 6.90.5211
AUC0-24484.9 ± 154.4528.1 ± 245.60.2931
AUC0-24/MIC640.6 ± 322.0635.7 ± 332.50.9458
AUC: Area under the curve; Cmin: Trough concentration; MIC: Minimum inhibitory concentration.
Table 3 Univariate logistic analyses between pharmacokinetics and clinical characteristics and efficacy, n (%)
Variable
Ineffective (n = 26)
Effective (n = 77)
OR
95%CI
P value
Sex0.98150.360-2.5170.9696
Female8 (30.8)24 (31.2)---
Male18 (69.2)53 (68.8)---
Age (years)0.87800.358-2.1500.7745
≤ 6513 (50.0)41 (53.2)---
> 6513 (50.0)36 (46.8)---
Weight (kg)0.60290.231-1.4920.2830
≤ 609 (34.6)36 (46.8)---
> 6017 (65.4)41 (53.2)---
Main etiologies of ICU cases0.50000.183-1.4210.1805
Postoperative infection18 (69.2)63 (81.8)---
Other8 (30.7)14 (18.2)---
Comorbidities0.55830.082-2.3150.4720
No2 (7.7)10 (13.0)---
Yes24 (92.3)67 (87.0)---
Infectious site0.79600.504-1.2570.3235
Abdominal cavity5 (19.2)17 (22.1)---
Lung9 (34.6)26 (33.8)---
Blood7 (26.9)29 (37.7)---
Chest cavity5 (19.2)5 (6.5)---
Daily dose (g)2.78400.892-8.4840.0709
≤ 1.1257 (26.9)9 (77.0)---
> 1.12519 (73.1)68 (88.3)---
APACHE II score0.71430.289-1.7430.4597
≤ 3512 (46.2)42 (54.5)---
> 3514 (53.8)35 (45.5)---
Mechanical ventilation1.18500.431-3.0760.7320
No8 (30.8)21 (27.3)---
Yes18 (69.2)56 (72.7)---
Cmin33.000010.440-130.700< 0.0001
≤ 9.422 (84.6)11 (14.3)---
> 9.44 (15.4)66 (85.7)---
AUC0-2419.64006.321-71.150< 0.0001
≤ 359.615 (57.7)5 (6.5)---
> 359.611 (42.3)72 (93.5)---
AUC0-24/MIC7.39602.405-24.6800.0006
≤ 359.610 (38.5)6 (7.8)---
> 359.616 (61.5)71 (92.2)---
APACHE: Acute physiological chronic health evaluation; AUC: Area under the curve; CI: Confidence interval; Cmin: Trough concentration; ICU: Intensive care unit; MIC: Minimum inhibitory concentration; OR: Odds ratio.
Table 4 Univariate logistic analyses between pharmacokinetics and clinical characteristics and nephrotoxicity, n (%)
Variable
Non-nephrotoxic (n = 76)
Nephrotoxic (n = 27)
OR
95%CI
P value
Sex1.09600.430-2.9770.8509
Female24 (31.6)8 (29.6)---
Male52 (68.4)19 (70.4)---
Age (years)1.26200.522-3.0680.6046
≤ 6541 (53.9)13 (46.4)---
> 6535 (46.1)14 (53.6)---
Weight (kg)1.17700.486-2.9270.7193
≤ 6034 (44.7)11 (40.7)---
> 6042 (55.3)16 (59.3)---
Main etiologies of ICU cases1.07100.347-2.9940.8987
Postoperative infection60 (78.9)21 (77.8)---
Other16 (21.1)6 (22.2)---
Comorbidities1.07500.292-5.1410.9190
No9 (11.8)3 (11.1)---
Yes67 (88.2)24 (88.9)---
Infectious site0.71870.432-1.1470.1808
Abdominal cavity18 (23.7)4 (14.8)---
Lung23 (30.2)12 (44.4)---
Blood27 (35.5)9 (33.3)---
Chest cavity7 (9.2)3 (11.1)---
Daily dose (g)1.46500.582-3.9470.4289
≤ 1.6529 (38.2)8 (29.6)---
> 1.6547 (61.8)19 (70.4)---
APACHE II score0.55800.220-1.3560.2047
≤ 3537 (48.7)17 (63.0)---
> 3539 (51.3)10 (37.0)---
Mechanical ventilation0.45100.177-1.1600.0945
No18 (23.7)11 (40.7)---
Yes58 (76.3)16 (38.2)---
Cmin (μg/mL)1.89400.771-4.6630.1612
≤ 14.051 (67.1)14 (51.9)---
> 14.025 (32.9)13 (48.1)---
AUC0-241.91700.792-4.7310.1508
≤ 500.546 (60.5)12 (44.4)---
> 500.530 (39.5)15 (55.5)---
AUC0-24/MIC1.37600.565-3.4850.4880
≤ 522.134 (44.7)10 (37.0)---
> 522.142 (55.3)17 (63.0)---
Data are presented as n (%). APACHE: Acute physiological chronic health evaluation; AUC: Area under the curve; CI: Confidence interval; Cmin: Trough concentration; ICU: Intensive care unit; MIC: Minimum inhibitory concentration; OR: Odds ratio.
Table 5 Multivariate logistic analyses between pharmacokinetics and efficacy
Variables
OR
95%CI
Wald χ2
P value
Intercept0.36170.011-8.8880.61650.5375
Sex0.55650.079-3.2290.63450.5257
Age0.34490.030-2.6560.97460.3298
Weight0.50510.089-2.6240.80850.4188
Main etiologies of ICU cases0.52060.076-3.2060.70110.4833
Comorbidities0.19240.016-1.5351.45200.1464
Infectious site0.97230.405-2.3110.06510.9481
Daily dose11.04001.752-109.2002.37000.0178
Cmin75.00009.551-1201.0003.64300.0003
AUC0-2428.77001.710-2026.0001.93200.0353
AUC0-24/MIC0.10490.002-1.7891.36100.1736
APACHE II score0.56060.100-2.9290.69100.4895
Mechanical ventilation2.55200.363-22.6800.91610.3596
APACHE: Acute physiological chronic health evaluation; AUC: Area under the curve; CI: Confidence interval; Cmin: Trough concentration; ICU: Intensive care unit; MIC: Minimum inhibitory concentration; OR: Odds ratio.
Table 6 Multivariate logistic analyses between pharmacokinetics and nephrotoxicity
Variables
OR
95%CI
Wald χ2
P value
Intercept0.28260.026-2.5651.09700.2727
Sex0.83830.255-2.8050.29190.7704
Age1.18700.449-3.1480.34840.7275
Weight1.15400.403-3.3930.26660.7898
Main etiologies of ICU cases1.16000.338-3.7000.24680.8051
Comorbidities1.07400.247-5.7810.09130.9272
Infectious site0.69460.395-1.1641.34000.1803
Daily dose2.54800.502-17.6501.06200.2882
Cmin2.99001.003-10.4701.86000.0429
AUC0-241.08100.151-5.8310.08720.9305
AUC0-24/MIC0.87630.258-2.9060.21600.8290
APACHE II score0.64850.212-1.9600.77140.4404
Mechanical ventilation0.50250.156-1.5921.17300.2407
APACHE: Acute physiological chronic health evaluation; AUC: Area under the curve; CI: Confidence interval; Cmin: Trough concentration; ICU: Intensive care unit; MIC: Minimum inhibitory concentration; OR: Odds ratio.