Population Pharmacokinetic Modeling and Dose Optimization of Vancomycin in Chinese Patients with Augmented Renal Clearance
| Autor: | Suodi Zhai, Chuhui Wang, Na He, Yahui Zhang, Sixuan Zhao, Chao Zhang |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Microbiology (medical)
medicine.medical_specialty augmented renal clearance area under the curve Population vancomycin Urology Renal function RM1-950 Biochemistry Microbiology Article Pharmacokinetics population pharmacokinetic model medicine Pharmacology (medical) General Pharmacology Toxicology and Pharmaceutics education Volume of distribution education.field_of_study business.industry Area under the curve NONMEM Infectious Diseases dosage regimens Vancomycin Therapeutics. Pharmacology business Clearance rate medicine.drug |
| Zdroj: | Antibiotics Volume 10 Issue 10 Antibiotics, Vol 10, Iss 1238, p 1238 (2021) |
| ISSN: | 2079-6382 |
| DOI: | 10.3390/antibiotics10101238 |
| Popis: | Patients with augmented renal clearance (ARC) have been described as having low vancomycin concentration. However, the pharmacokinetic model that best describes vancomycin in patients with ARC has not been clarified. The purpose of this study is to determine the pharmacokinetic of vancomycin in Chinese adults and the recommend dosage for patients with different renal function, including patients with ARC. We retrospectively collected 424 vancomycin serum concentrations from 209 Chinese patients and performed a population pharmacokinetic model using NONMEM 7.4.4. The final model indicated that the clearance rate of vancomycin increased together with the creatinine clearance, and exhibited a nearly saturated curve at higher creatinine clearance. The estimated clearance of vancomycin was between 3.46 and 5.58 L/h in patients with ARC, with 5.58 being the maximum theoretical value. The central volume of distribution increased by more than three times in patients admitted to Intensive Care Unit. Monte Carlo simulations were conducted to explore the probability of reaching the target therapeutic range (24-h area under the curve: 400–650 mg·h/L, trough concentration: 10–20 mg/L) when various dose regimens were administered. The simulations indicated that dose should increase together with the creatinine clearance until 180 mL/min. These findings may contribute to improving the efficacy and safety of vancomycin in patients with ARC. |
| Databáze: | OpenAIRE |
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