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Population Pharmacokinetic Modeling and Dose Optimization of Vancomycin in Chinese Patients with Augmented Renal Clearance

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机构: [1]Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China [2]Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Science, Peking University, Beijing 100191, China [3]Department of Pharmacy, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
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关键词: area under the curve augmented renal clearance dosage regimens population pharmacokinetic model vancomycin

摘要:
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 & BULL;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.</p>

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出版当年[2020]版:
大类 | 3 区 医学
小类 | 3 区 传染病学 3 区 药学
最新[2023]版:
大类 | 2 区 医学
小类 | 2 区 药学 3 区 传染病学
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出版当年[2019]版:
Q1 INFECTIOUS DISEASES Q1 PHARMACOLOGY & PHARMACY
最新[2023]版:
Q1 INFECTIOUS DISEASES Q1 PHARMACOLOGY & PHARMACY

影响因子: 最新[2023版] 最新五年平均 出版当年[2019版] 出版当年五年平均 出版前一年[2018版] 出版后一年[2020版]

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第一作者机构: [1]Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China
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通讯机构: [1]Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China [2]Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Science, Peking University, Beijing 100191, China
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