Population pharmacokinetics analysis of vancomycin in critically ill patients

Wanchai Treyaprasert

Abstract


Objectives: The aim of this study was to determine population pharmacokinetic parameters of vancomycin in adult critically ill patients and to investigate the covariates affecting population pharmacokinetic parameters.

Methods: Plasma concentration data from therapeutic drug monitoring were collected from retrospective study. Vancomycin population pharmacokinetic modeling was analyzed using nonlinear mixed effect model (NONMEM) program.

Results: A population pharmacokinetic was developed by using 398 plasma concentration data from 171 patients. Creatinine clearance, comorbidity with diabetes mellitus and sepsis were found significantly influence CL whereas V of vancomycin showed the significant dependence on patient serum creatinine and gender. The final model parameters were CL(L/h) = 3.63 x (CRCL/67.7)0.768 x [1 + (-0.243x DM)] x [1 + (-0.225x SEPS)] and V(L)= 118x [(SCR/0.9)-0.209] x [1+(-0.237x SEX)]. Results from the model evaluation suggested the accuracy and the robustness of the final model.

Conclusions: A population pharmacokinetic model of vancomycin for critically ill patients with gram-positive infections was developed in this study. The significant covariates distinguished in the final model can provide helpful information to facilitate individualized therapy with similar patient population characteristics.


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References


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