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Besides, Toutain and Lees thought that the parameters derived from PK/PD modelling may be used as an alternative and preferred approach to dose titration studies for selecting rational dosage regimens (both dose and dosing interval) for further evaluation in clinical trials [ 3].
An alternative approach to dose escalation to increase systemic 4-HPR levels is pharmacological modulation of 4-HPR metabolism.
This has been referred to as a "physiologic approach" to dose selection (vom Saal et al. 1998).
For daily practice it seems reasonable to use the CG equation as a more conservative approach to dose adjustment in renal impairment.
In a conventional approach to dose finding, the doses need to be reduced early in the phase 2 studies to determine which concentration profiles are necessary for cure.
An alternative approach to dose finding is to define the in vivo MIC as the primary objective of phase 2 studies.
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Until drug assays are routinely available, a personalized approach to dosing should be considered for each patient based on local AMS.
Patients may have an "as needed" approach to dosing, taking doses to treat symptoms or lessen side effects (Dunbar-Jacob and Mortimer-Stephens 2001; Marder 2003; Pound et al. 2005).
Despite these concerns and limitations, all participants of the workshop agreed that an M&S approach to dose-regimen selection may be helpful in providing insight into the "true" dose exposure response relationship.
Given the sources of beta-lactam pharmacokinetic variability highlighted, Ulldemolins and colleagues suggest a general approach to dosing of patients.
Similarly, the lack of a pharmacokinetic pharmacodynamic relationship for cisplatin may explain why such an approach to dosing has not been established for this drug.
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