Vancomycin population pharmacokinetics and dosing proposal for the initial treatment in obese adult patients

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064211%3A_____%2F24%3AW0000027" target="_blank" >RIV/00064211:_____/24:W0000027 - isvavai.cz</a>

Result on the web

<a href="https://oadoi.org/10.3389/fphar.2024.1364681" target="_blank" >https://oadoi.org/10.3389/fphar.2024.1364681</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.3389/fphar.2024.1364681" target="_blank" >10.3389/fphar.2024.1364681</a>

Result language

angličtina

Original language name

Vancomycin population pharmacokinetics and dosing proposal for the initial treatment in obese adult patients

Original language description

Aim The aim of this study was to develop a vancomycin population pharmacokinetic model in adult obese patients and propose covariate-based dosing individualization in order to maximize the achievement of the newly recommended PK/PD target, according to a revised consensus guideline from 2020.Methods Therapeutic drug monitoring data from initial vancomycin therapy (first 3 days of treatment) in adult obese (BMI >= 30 kg/m2) patients from 2013 to 2022 were analyzed using a non-linear mixed-effects modeling method, and Monte Carlo simulations were then used to find the optimal dosage maximizing the PK/PD target attainment.Results A total of 147 vancomycin serum levels obtained from 138 patients were included in the analysis. Based on the covariate model diagnosis among all tested variables, no reliable predictor of vancomycin volume of distribution (Vd) was identified, while clearance (CL) was positively correlated with eGFR and lean body mass. Creatinine-based eGFR predicted vancomycin CL better than cystatin C-based eGFR. The median (interquartile range) value from conditional modes of individual estimates of Vd, CL, and elimination half-life in our population was 74.0 (70.5-75.4) L, 6.65 (4.95-8.42) L/h, and 7.7 (6.0-10.0) h, respectively.Conclusion We proposed dosing individualization based on the covariate found in order to maximize the achievement of the newly recommended PK/PD target of the AUC/MIC ratio of 400-600. Clinical pharmacy/pharmacology interventions may lead to an improvement in vancomycin dosing with a reflection in PK/PD target attainment.

Czech name

—

Czech description

—

Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30104 - Pharmacology and pharmacy

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2024

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

FRONTIERS IN PHARMACOLOGY

ISSN

—

e-ISSN

1663-9812

Volume of the periodical

15

Issue of the periodical within the volume

JUN 4

Country of publishing house

CH - SWITZERLAND

Number of pages

10

Pages from-to

-

UT code for WoS article

001249675400001

EID of the result in the Scopus database

—