Assessing the accuracy of two Bayesian forecasting programs in estimating vancomycin drug exposure.
J Antimicrob Chemother
; 75(11): 3293-3302, 2020 11 01.
Article
em En
| MEDLINE
| ID: mdl-32790842
ABSTRACT
BACKGROUND:
Current guidelines for intravenous vancomycin identify drug exposure (as indicated by the AUC) as the best pharmacokinetic (PK) indicator of therapeutic outcome.OBJECTIVES:
To assess the accuracy of two Bayesian forecasting programs in estimating vancomycin AUC0-∞ in adults with limited blood concentration sampling.METHODS:
The 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.RESULTS:
Optimal 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. 40 212-21) and Thomson et al. (J Antimicrob Chemother 2009. 63 1050-7) had precise and unbiased sampling times (defined as mean imprecision <25% and <38 mg·h/L, with 95% CI for mean bias containing zero) between 1.5 and 6â h and between 0.75 and 2â h post-infusion, respectively. Precise but biased sampling times for Thomson et al. were between 4 and 6 h post-infusion.CONCLUSIONS:
When 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.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Preparações Farmacêuticas
/
Vancomicina
Tipo de estudo:
Guideline
/
Prognostic_studies
Limite:
Adult
/
Humans
Idioma:
En
Revista:
J Antimicrob Chemother
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Austrália