Pharmacokinetics of Vancomycin among Patients with Chemotherapy-Associated Febrile Neutropenia: Which Would Be the Best Dosing to Obtain Appropriate Exposure?

Autor:	Parra González D; Department of Pharmacy, Faculty of Sciences, Universidad Nacional de Colombia, Bogotá 111321, Colombia., Pérez Mesa JA; Faculty of Medicine, Universidad Nacional de Colombia, Bogotá 111321, Colombia., Cuervo Maldonado SI; Faculty of Medicine, Universidad Nacional de Colombia, Bogotá 111321, Colombia.; Grupo de Investigación en Enfermedades Infecciosas en Cáncer y Alteraciones Hematológicas (GREICAH), Universidad Nacional de Colombia, Bogotá 111321, Colombia.; Instituto Nacional de Cancerología (INC)-Empresa Social del Estado, Bogotá 111511, Colombia., Díaz Rojas JA; Department of Pharmacy, Faculty of Sciences, Universidad Nacional de Colombia, Bogotá 111321, Colombia.; Grupo de Investigación en Enfermedades Infecciosas en Cáncer y Alteraciones Hematológicas (GREICAH), Universidad Nacional de Colombia, Bogotá 111321, Colombia.; Group on Research in Infectious Diseases, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá 111321, Colombia., Cortés JA; Faculty of Medicine, Universidad Nacional de Colombia, Bogotá 111321, Colombia.; Group on Research in Infectious Diseases, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá 111321, Colombia., Silva Gómez E; Department of Pharmacy, Faculty of Sciences, Universidad Nacional de Colombia, Bogotá 111321, Colombia.; Grupo de Investigación en Enfermedades Infecciosas en Cáncer y Alteraciones Hematológicas (GREICAH), Universidad Nacional de Colombia, Bogotá 111321, Colombia., Saavedra Trujillo CH; Faculty of Medicine, Universidad Nacional de Colombia, Bogotá 111321, Colombia.; Group on Research in Infectious Diseases, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá 111321, Colombia., Gómez J; Grupo de Investigación en Enfermedades Infecciosas en Cáncer y Alteraciones Hematológicas (GREICAH), Universidad Nacional de Colombia, Bogotá 111321, Colombia.; Instituto Nacional de Cancerología (INC)-Empresa Social del Estado, Bogotá 111511, Colombia.
Jazyk:	angličtina
Zdroj:	Antibiotics (Basel, Switzerland) [Antibiotics (Basel)] 2022 Nov 01; Vol. 11 (11). Date of Electronic Publication: 2022 Nov 01.
DOI:	10.3390/antibiotics11111523
Abstrakt:	Previous research has determined that the required doses for treating febrile neutropenia with vancomycin are higher than the doses used conventionally. These recommendations have been made considering pharmacotherapeutic goals based on minimum concentration (Cmin) between 15-20 mg/L. This study was developed to evaluate dose recommendations based on the achievement of a target consisting of ratio of area under the curve over minimum inhibitory concentration (AUC24h/MIC) ≥400 in this population of individuals. This study was conducted in a referral hospital for cancer treatment, study participants received vancomycin doses of 1g every 12 h in 2-4-h infusions. Vancomycin was described by a two-compartment pharmacokinetic model with clearance dependent on the estimated glomerular filtration rate. Simulations were performed taking into account a reduced version of the model to establish the influence of controllable and non-controllable variables on the probability of achieving several PK-PD targets. A dose of 2.5g/day in patients with estimated glomerular filtration rate (eGFR) between 80 and 122mL/min/1.73m2 was adequate to achieve the pharmacotherapeutic target. A discrepancy was found between AUC-based and Cmin-based PK/PD indices, the former being affected by the dose and creatinine clearance while the latter highly influenced by the interval between doses.
Databáze:	MEDLINE
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