With the current trial testing faster infusion of lower doses, peak plasma concentrations will be interesting.
For the peak rate of 3,000mg over 15 minutes, we will hopefully see higher peak plasma concentrations than we achieved at 6,000mg over 1 hour.
My guess is peak plasma concentration for that dose rate will be 400-500ppm. Which would really still be too low to be useful for targeting blood-borne bacteria (sepsis), especially when plasma levels likely drop very quickly after the peak.
The lower dose will likely mean that peak urine concentrations will be lower than that achieved with 6,000mg over 1 hour. Maybe in the range of 700-1200ppm. Depending on the pathogen, the higher longer dose would be required in some cases.
Another point to note is the trial will test a range of different 327 concentrations - from 4mg/mL to 8mg/mL. So infusion volume of between 313mL and 750mL. Does anyone know what the concentration was for the 1 hour trial? I can't find it anywhere. But it's possible that giving a lower volume (higher concentration) may result in slower urine production and slower loss of 327 from plasma to urine.
Lots of unknowns and theories.
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