Establishment and application of population pharmacokinetics model of vancomycin in infants with meningitis

Xu, Jianwen; Zhu, Yanting; Niu, Peiguang; Liu, Ying; Li, Danyun; Jiang, Li; Shi, Daohua

doi:10.1016/j.pedneo.2021.06.018

Cited by 3 publications

(4 citation statements)

References 45 publications

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“…Moreover, we studied the NEAB's selectivity against relevant interfering species. Figure S7 (B and C) shows that the tested biosensors' responses are minimally affected (<5%) by the presence of common endogenous molecules and frequently coadministered drugs [here, ibuprofen and azithromycin; also relevant to vancomycin monitoring (44)(45)(46)(47)].…”

Section: Resultsmentioning

confidence: 99%

Wearable microneedle-based electrochemical aptamer biosensing for precision dosing of drugs with narrow therapeutic windows

et al. 2022

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Therapeutic drug monitoring is essential for dosing pharmaceuticals with narrow therapeutic windows. Nevertheless, standard methods are imprecise and involve invasive/resource-intensive procedures with long turnaround times. Overcoming these limitations, we present a microneedle-based electrochemical aptamer biosensing patch (μNEAB-patch) that minimally invasively probes the interstitial fluid (ISF) and renders correlated, continuous, and real-time measurements of the circulating drugs’ pharmacokinetics. The μNEAB-patch is created following an introduced low-cost fabrication scheme, which transforms a shortened clinical-grade needle into a high-quality gold nanoparticle-based substrate for robust aptamer immobilization and efficient electrochemical signal retrieval. This enables the reliable in vivo detection of a wide library of ISF analytes—especially those with nonexistent natural recognition elements. Accordingly, we developed μNEABs targeting various drugs, including antibiotics with narrow therapeutic windows (tobramycin and vancomycin). Through in vivo animal studies, we demonstrated the strong correlation between the ISF/circulating drug levels and the device’s potential clinical use for timely prediction of total drug exposure.

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Section: Resultsmentioning

confidence: 99%

Wearable microneedle-based electrochemical aptamer biosensing for precision dosing of drugs with narrow therapeutic windows

et al. 2022

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“…Included in this review were eight population PK studies gathering data from a total of 2523 patients with an average of 9% (N = 228) receiving a loop diuretic [ 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ]. The median and range of age, weight, and eGFR across the studies were 26.65 years (0.65–65), 65.55 kg (2.17–88), and 98.97 mL/min (39.24–120.6), respectively.…”

Section: Resultsmentioning

confidence: 99%

Systematic Review and Meta-Analysis of the Effect of Loop Diuretics on Antibiotic Pharmacokinetics

et al. 2023

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Loop diuretics and antibiotics are commonly co-prescribed across many clinical care settings. Loop diuretics may alter antibiotic pharmacokinetics (PK) via several potential drug interactions. A systematic review of the literature was performed to investigate the impact of loop diuretics on antibiotic PK. The primary outcome metric was the ratio of means (ROM) of antibiotic PK parameters such as area under the curve (AUC) and volume of distribution (Vd) on and off loop diuretics. Twelve crossover studies were amenable for metanalysis. Coadministration of diuretics was associated with a mean 17% increase in plasma antibiotic AUC (ROM 1.17, 95% CI 1.09–1.25, I2 = 0%) and a mean decrease in antibiotic Vd by 11% (ROM 0.89, 95% CI 0.81–0.97, I2 = 0%). However, the half-life was not significantly different (ROM 1.06, 95% CI 0.99–1.13, I2 = 26%). The remaining 13 observational and population PK studies were heterogeneous in design and population, as well as prone to bias. No large trends were collectively observed in these studies. There is currently not enough evidence to support antibiotic dosing changes based on the presence or absence of loop diuretics alone. Further studies designed and powered to detect the effect of loop diuretics on antibiotic PK are warranted in applicable patient populations.

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“…However, the guidelines mention that this was a weak recommendation, and the quality of evidence was very low. Vancomycin doses lower than the dose recommended by the IDSA have been observed in some studies of Chinese infants 31–33 . The dosage of 60–80 mg/kg/day may not be needed for Chinese infants with normal renal function.…”

Section: Discussionmentioning

confidence: 99%

“…Vancomycin doses lower than the dose recommended by the IDSA have been observed in some studies of Chinese infants. [31][32][33] The dosage of 60-80 mg/kg/day may not be needed for Chinese infants with normal renal function. The efficacy and safety of higher dosages should be further evaluated in Chinese infants with normal renal function.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Vancomycin Clearance Between Augmented Renal Clearance and Normal Renal Function in Critically Ill Infants: A Population Pharmacokinetics Study

Guang-ming

Qiu

Liu

et al. 2022

The Journal of Clinical Pharma

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Augmented renal clearance presents as super-renal function with enhanced renal perfusion and glomerular hyperfiltration in many critically ill infants. This study was to compare vancomycin clearance (CL) between critically ill infants with augmented renal clearance and with normal renal function and to optimize the vancomycin dosage. Data were retrospectively obtained from infants treated in intensive care units. Population pharmacokinetics analysis was conducted using nonlinear mixed-effects model software. A total of 66 critically ill infants were included: 47 infants with augmented renal clearance and 19 infants with normal renal function. The median doses of vancomycin for infants with augmented renal clearance and with normal renal function were 48 and 47 mg/kg/day (P > .05), respectively. The median CL in infants with augmented renal clearance was increased 1.96-fold compared with infants who had normal renal function (0.98 versus 0.5 L/h, P < .001). Simulations indicated that the recommended dosage of 60, 70, 80, 90, and 100 mg/kg/day would be appropriate in critically ill infants with an estimated glomerular filtration rate (eGFR) of 130-149, 150-169, 170-189, 190-209, and >210 mL/min/1.73 m 2 , respectively. Doses of 70 and 75 mg/kg/day were recommended for infants with augmented renal clearance and gestational ages of 27-32.9 and 33-39 weeks, respectively. Doses of 70, 75, 80, and 90 mg/kg/day were recommended for infants with augmented renal clearance and weights of 2.0-2.9, 3.0-3.9, 4.0-4.9, and 5.0-6.0 kg, respectively. In conclusion, the typical vancomycin dosage is insufficient for critically ill infants with augmented renal clearance. Premature infants and infants of low weight with augmented renal clearance need individualized dosing regimens to obtain an adequate area under the serum concentration time curve over 24 h/minimum inhibitory concentration ratio.

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Establishment and application of population pharmacokinetics model of vancomycin in infants with meningitis

Cited by 3 publications

References 45 publications

Wearable microneedle-based electrochemical aptamer biosensing for precision dosing of drugs with narrow therapeutic windows

Wearable microneedle-based electrochemical aptamer biosensing for precision dosing of drugs with narrow therapeutic windows

Systematic Review and Meta-Analysis of the Effect of Loop Diuretics on Antibiotic Pharmacokinetics

Comparison of Vancomycin Clearance Between Augmented Renal Clearance and Normal Renal Function in Critically Ill Infants: A Population Pharmacokinetics Study

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