DosOpt: A Tool for Personalized Bayesian Dose Adjustment of Vancomycin in Neonates

Therapeutic Drug Monitoring
Tõnis TasaIrja Lutsar


Our main aim has been to design a framework to improve vancomycin dosing in neonates. This required the development and verification of a computerized dose adjustment application, DosOpt, to guide the selection. Model fitting in DosOpt uses Bayesian methods for deriving individual pharmacokinetic (PK) estimates from population priors and patient therapeutic drug monitoring measurements. These are used to simulate concentration-time curves and target-constrained dose optimization. DosOpt was verified by assessing bias and precision through several error metrics and normalized prediction distribution errors on samples simulated from the Anderson et al PK model. The performance of DosOpt was also evaluated using retrospective clinical data. Achieved probabilities of target concentration attainment were benchmarked against corresponding attainments in our clinical retrospective data set. Simulations showed no systemic forecast biases. Normalized prediction distribution error values of the base model were distributed by standardized Gaussian (P = 0.1), showing good model suitability. A retrospective test data set included 149 treatment episodes with 1-10 vancomycin concentration measurements per patient (median 2). Individual concen...Continue Reading


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