Abstract:
PURPOSE:Vancomycin (VCM) concentration is often out of therapeutic range (10-20 μg/ml) in patients receiving continuous renal replacement therapy (CRRT). The purposes of this study were to develop a practical VCM population pharmacokinetic (PPK) model and to evaluate the potential of Bayesian prediction-based therapeutic drug monitoring (Bayes-TDM) in VCM dose individualization for patients receiving CRRT. METHODS:We developed a VCM PPK model using 80 therapeutic concentrations in 17 patients receiving CRRT. Bayes-TDM with the VCM PPK model was evaluated in 23 patients after PPK modeling. RESULTS:We identified the covariates reduced urine output (RUO, <0.5 ml/kg/h) and effluent flow rate of CRRT for the VCM PPK model. The mean VCM non CRRT clearance (CLnonCRRT) was 2.12 l/h. RUO lowered CLnonCRRT to 0.34 l/h. The volume of distribution was 91.3 l/70 kg. The target concentration attainment rate by Bayes-TDM was higher (87.0%) than that by the PPK modeling period (53.8%, P = 0.046). The variance of the second measured concentrations by the Bayes-TDM was lower (11.5, standard deviation: 3.4 μg/ml) than that by the PPK modeling period (50.5, standard deviation: 7.1 μg/ml, P = 0.003). CONCLUSIONS:Bayes-TDM could be a useful tool for VCM dose individualization in patients receiving CRRT.
journal_name
Pharm Resjournal_title
Pharmaceutical researchauthors
Oda K,Jono H,Kamohara H,Nishi K,Tanoue N,Saito Hdoi
10.1007/s11095-020-02820-0subject
Has Abstractpub_date
2020-05-28 00:00:00pages
108issue
6eissn
0724-8741issn
1573-904Xpii
10.1007/s11095-020-02820-0journal_volume
37pub_type
杂志文章abstract::Despite substantial research carried out over the last decades, it remains difficult to understand the wide range of pharmacological effects of dopaminergic agents. The dopaminergic system is involved in several neurological disorders, such as Parkinson's disease and schizophrenia. This complex system features multipl...
journal_title:Pharmaceutical research
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journal_title:Pharmaceutical research
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更新日期:2008-04-01 00:00:00
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更新日期:2013-06-01 00:00:00
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