Population pharmacokinetic model of Vancomycin based on therapeutic drug monitoring data in critically ill septic patients

Kovačević, Tijana; Miljković, Branislava; Kovačević, Peđja; Dragic, Sasa; Momčičević, Danica; Avram, Sanja; Jovanović, Marija; Vučićević, Katarina

doi:10.1016/j.jcrc.2019.10.012

Cited by 17 publications

(11 citation statements)

References 20 publications

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“…In the present study, vancomycin CL had linear relationships with creatinine CL, whereas and the Vd was correlated with actual body weight. These correlations were also observed in several previous studies [17][18][19]. Surprisingly, patient age was also correlated with the Vd of vancomycin.…”

Section: Discussionsupporting

confidence: 87%

Vancomycin Area under the Curve and Pharmacokinetic Parameters during the First 24 Hours of Treatment in Critically Ill Patients using Bayesian Forecasting

et al. 2020

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Background: Currently, the achievement of the target area under the curve (AUC)/ minimum inhibitory concentration ratio during the first 24 -48 h of treatment is associated with reduced 30-day mortality and greater microbiological eradication in patients with methicillin-resistant Staphylococcus aureus bacteremia. This study aimed to determine the AUC and pharmacokinetic parameters on the first day of vancomycin administration based on the Bayesian theorem to optimize the dosing regimen in critically ill patients. Materials and Methods: This retrospective study included participants meeting the following criteria: 1) ≥18 years old; 2) receipt of at least one dose of vancomycin; 3) measurement of 2 vancomycin serum concentrations during the first 24 h of treatment; and 4) an intensive care unit admission, mechanical ventilator use, or an Acute Physiology and Chronic Health Evaluation II score >15 points. The AUC on day 1 of treatment and the estimated vancomycin pharmacokinetic parameters were measured using PrecisePK software based on the Bayesian theorem. Results: We obtained 132 vancomycin concentrations from 66 patients. The vancomycin pharmacokinetic parameters were as follows: AUC 0-24 , 571.09 (± standard deviation [

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Section: Discussionsupporting

confidence: 87%

Vancomycin Area under the Curve and Pharmacokinetic Parameters during the First 24 Hours of Treatment in Critically Ill Patients using Bayesian Forecasting

et al. 2020

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“…The estimated GFR was another important covariate that influenced CL of vancomycin in the kidney transplant recipients. GFR has been already identified as a major covariate for the pharmacokinetic parameters CL of vancomycin in patients with infectious diseases (Kovacevic et al, 2020). CL of vancomycin was lower in patients with decreased creatinine clearance due to aging, and the vancomycin CL was higher in patients with augmented GFR (Usman et al, 2018;Molina et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Population Pharmacokinetics of Vancomycin in Kidney Transplant Recipients: Model Building and Parameter Optimization

Liu

Jiao

et al. 2020

Front. Pharmacol.

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Background: Depending on the renal function of patients and many other influencing factors, studies on vancomycin pharmacokinetics show significant inter-and intraindividual variability. The present study was conducted using a population pharmacokinetics method to investigate the pharmacokinetic parameters and identified their influencing covariates for intravenous vancomycin in adult kidney transplant recipients. Methods:The drug monitoring data included 56 adult renal transplant recipients who received intravenous vancomycin as prophylactic medication. The analysis was performed by a population approach with NONMEM. Data were collected mainly during the first week after transplantation. Monitoring of vancomycin trough concentration in blood was initiated mainly 3-5 days after the initial administration. Results:The one-compartment open model was optimal and adequately described the data. Body weight (WT) and estimated glomerular filtration rate (GFR) were identified as significant covariates of the pharmacokinetic parameters CL and V of intravenous vancomycin in the kidney transplant patients. The typical values of vancomycin CL and V were 2.08 L h -1 and 63.2 L, respectively. A dosage strategy scheme according to model results was also designed. Conclusion:Both WT and GFR of the kidney transplant patients positively influence the pharmacokinetic parameters CL and V for intravenous vancomycin. Our population

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“…The simulations of vancomycin dosing based on the renal status of patients indicated that 800–1,000 mg of vancomycin administered every 12 h is sufficient for maintaining the trough concentration of vancomycin between 10 and 20 mg/l in patients with CRCL of 100 and 140 ml/min, while administration of the same dose to patients with compromised renal status may lead to the accumulation of vancomycin; therefore, a dose of 400 and 600 mg is recommended if the CRCL of the patients is 20 and 60 ml/min, respectively. The dosing simulations for vancomycin in patients with estimated GFR reduction have also been previously performed in a similar study in which a 1,000-mg q12h dose of vancomycin was simulated in patients with a mild, moderate, or severe reduction in GFR ( Kovacevic et al, 2020 ). A dose of 1,000 mg q12h was also simulated based on the serum cystatin C levels of the patients in another study ( Chung et al, 2013 ).…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, studies in different ethnic groups are also available regarding the population pharmacokinetics of vancomycin ( Purwonugroho et al, 2012 ; Deng et al, 2013 ; Zhou et al, 2019 ). Simulations of different dosage regimens to maintain trough concentrations of vancomycin between 10 and 20 mg/l have been performed in different clinical cases such as critically ill patients ( Kovacevic et al, 2020 ), pneumonia patients ( Yamamoto et al, 2009 ), and patients with hematological malignancies ( Buelga et al, 2005 ). The covariates considered for dosing simulations in different studies have included high-volume hemofiltration ( Escobar et al, 2014 ) serum cystatin C ( Chung et al, 2013 ), and creatinine clearance ( Purwonugroho et al, 2012 ).…”

Section: Introductionmentioning

confidence: 99%

Dose Tailoring of Vancomycin Through Population Pharmacokinetic Modeling Among Surgical Patients in Pakistan

et al. 2021

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Background: Vancomycin is a narrow therapeutic agent, and it is necessary to optimize the dose to achieve safe therapeutic outcomes. The purpose of this study was to identify the significant covariates for vancomycin clearance and to optimize the dose among surgical patients in Pakistan.Methods: Plasma concentration data of 176 samples collected from 58 surgical patients treated with vancomycin were used in this study. A population pharmacokinetic model was developed on NONMEM® using plasma concentration–time data. The effect of all available covariates was evaluated on the pharmacokinetic parameters of vancomycin by stepwise covariate modeling. The final model was evaluated using bootstrap, goodness-of-fit plots, and visual predictive checks.Results: The pharmacokinetics of vancomycin followed a one-compartment model with first-order elimination. The vancomycin clearance (CL) and volume of distribution (Vd) were 2.45 L/h and 22.6 l, respectively. Vancomycin CL was influenced by creatinine clearance (CRCL) and body weight of the patients; however, no covariate was significant for its effect on the volume of distribution. Dose tailoring was performed by simulating dosage regimens at a steady state based on the CRCL of the patients. The tailored doses were 400, 600, 800, and 1,000 mg for patients with a CRCL of 20, 60, 100, and 140 ml/min, respectively.Conclusion: Vancomycin CL is influenced by CRCL and body weight of the patient. This model can be helpful for the dose tailoring of vancomycin based on renal status in Pakistani patients.

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Population pharmacokinetic model of Vancomycin based on therapeutic drug monitoring data in critically ill septic patients

Cited by 17 publications

References 20 publications

Vancomycin Area under the Curve and Pharmacokinetic Parameters during the First 24 Hours of Treatment in Critically Ill Patients using Bayesian Forecasting

Vancomycin Area under the Curve and Pharmacokinetic Parameters during the First 24 Hours of Treatment in Critically Ill Patients using Bayesian Forecasting

Population Pharmacokinetics of Vancomycin in Kidney Transplant Recipients: Model Building and Parameter Optimization

Dose Tailoring of Vancomycin Through Population Pharmacokinetic Modeling Among Surgical Patients in Pakistan

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