Assessing the accuracy of two Bayesian forecasting programs in estimating vancomycin drug exposure
Autor: | Sophie L. Stocker, Garry G. Graham, Rashmi V Shingde, Richard O. Day, Kenneth M. Williams, Jane E. Carland, Stephanie E. Reuter |
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Přispěvatelé: | Shingde, Rashmi V, Reuter, Stephanie E, Graham, Garry G, Carland, Jane E, Williams, Kenneth M, Day, Richard O, Stocker, Sophie L |
Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Adult
0301 basic medicine Microbiology (medical) Drug intravenous vancomycin media_common.quotation_subject 030106 microbiology Bayesian probability Population 030226 pharmacology & pharmacy 03 medical and health sciences 0302 clinical medicine Pharmacokinetics Vancomycin Statistics medicine Humans Pharmacology (medical) education media_common Sampling bias Pharmacology education.field_of_study business.industry Sampling (statistics) Bayes Theorem Bayesian estimation post-infusion Infectious Diseases Pharmaceutical Preparations Area Under Curve Administration Intravenous Sample collection business medicine.drug |
Popis: | BackgroundCurrent guidelines for intravenous vancomycin identify drug exposure (as indicated by the AUC) as the best pharmacokinetic (PK) indicator of therapeutic outcome.ObjectivesTo assess the accuracy of two Bayesian forecasting programs in estimating vancomycin AUC0–∞ in adults with limited blood concentration sampling.MethodsThe application of seven vancomycin population PK models in two Bayesian forecasting programs was examined in non-obese adults (n = 22) with stable renal function. Patients were intensively sampled following a single (1000 mg or 15 mg/kg) dose. For each patient, AUC was calculated by fitting all vancomycin concentrations to a two-compartment model (defined as AUCTRUE). AUCTRUE was then compared with the Bayesian-estimated AUC0–∞ values using a single vancomycin concentration sampled at various times post-infusion.ResultsOptimal sampling times varied across different models. AUCTRUE was generally overestimated at earlier sampling times and underestimated at sampling times after 4 h post-infusion. The models by Goti et al. (Ther Drug Monit 2018;40212–21) and Thomson et al. (J Antimicrob Chemother 2009;631050–7) had precise and unbiased sampling times (defined as mean imprecision ConclusionsWhen using a single vancomycin concentration for Bayesian estimation of vancomycin drug exposure (AUC), the predictive performance was generally most accurate with sample collection between 1.5 and 6 h after infusion, though optimal sampling times varied across different population PK models. |
Databáze: | OpenAIRE |
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