Hospitalized Patients With and Without Hemodialysis Have Markedly Different Vancomycin Pharmacokinetics: A Population Pharmacokinetic Model-Based Analysis.

Therapeutic Drug Monitoring
Vineet GotiJesse T Jacob

Abstract

Despite being in clinical use for about 6 decades, vancomycin dosing remains perplexing and complex. A population pharmacokinetic modeling and simulation approach was used to evaluate the efficiency of the current nomogram-based dosing of vancomycin. Serum vancomycin concentrations were obtained as a part of routine therapeutic drug monitoring from two 500-bed academic medical centers. A population pharmacokinetic model was first built using these therapeutic drug monitoring data. Population pharmacokinetic modeling was conducted using NONMEM (7.2 and 7.3). The forward addition-backward elimination approach was used to test the covariate effects. Appropriate numerical and visual criteria were used as model diagnostics for checking model appropriateness and model qualification. The current nomogram efficiency was evaluated by determining the percentage of subjects in the therapeutic range (10-20 mg/L). A 2-compartment model with between-subject variability on clearance (CL), central volume of distribution (Vc), and peripheral volume of distribution best fit the data. Blood urea nitrogen, age, creatinine clearance, and hemodialysis status were significant covariates on clearance. Hemodialysis status was a significant covariate on...Continue Reading

References

Jan 1, 1976·Nephron·D W Cockcroft, M H Gault
Jun 1, 1988·Antimicrobial Agents and Chemotherapy·K A RodvoldL J Riff
Dec 1, 1984·The Journal of Antimicrobial Chemotherapy·J J GaraudF Vachon
Apr 1, 1984·Antimicrobial Agents and Chemotherapy·G R MatzkeW F Keane
Apr 1, 1983·Antimicrobial Agents and Chemotherapy·N BrownG P Bodey
Apr 1, 1982·Antimicrobial Agents and Chemotherapy·R A BlouinW O Griffen
Sep 1, 1982·Antimicrobial Agents and Chemotherapy·John C RotschaferL D Solem
Nov 1, 1981·Reviews of Infectious Diseases·Robert C MoelleringD J Greenblatt
Nov 1, 1981·Reviews of Infectious Diseases·B A CunhaC H Nightingale
Apr 1, 1980·Journal of Clinical Pharmacology·D J KrogstadD J Greenblatt
Feb 25, 1998·Clinical Pharmacokinetics·B M PowerK F Ilett
Apr 29, 1998·Therapeutic Drug Monitoring·M YasuharaR Hori
Apr 9, 1999·Computer Methods and Programs in Biomedicine·E Niclas Jonsson, Mats O Karlsson
Apr 24, 1999·Computer Methods and Programs in Biomedicine·J ParkeB G Charles
Apr 30, 1999·Pharmacotherapy·C M KaramMichael J Rybak
Jun 26, 1999·British Journal of Clinical Pharmacology·C M KirkpatrickE J Begg
Dec 19, 2000·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·S K Fridkin
Jan 5, 2002·Journal of Pharmacokinetics and Pharmacodynamics·S L Beal
Jul 27, 2002·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Suma PrakashRobert M Lindsay
Sep 13, 2002·Critical Care : the Official Journal of the Critical Care Forum·Vincent Launay-VacherGilbert Deray
Jul 19, 2005·Computer Methods and Programs in Biomedicine·Lars LindbomNiclas Jonsson
Aug 27, 2005·British Journal of Clinical Pharmacology·Hussain Mulla, Suneel Pooboni
Sep 9, 2006·Journal of Clinical Pharmacy and Therapeutics·P Llopis-Salvia, N V Jiménez-Torres
Dec 14, 2006·Intensive Care Medicine·Maria del Mar Fernández de Gatta GarciaAmparo Sánchez Navarro
Jul 7, 2007·Pharmaceutical Research·Andrew C HookerMats O Karlsson
Feb 25, 2009·Critical Care Medicine·Jason A Roberts, Jeffrey Lipman
Mar 21, 2009·The Journal of Antimicrobial Chemotherapy·A H ThomsonA M Lovering
Oct 31, 2009·Burns : Journal of the International Society for Burn Injuries·Michael DoltonAndrew J McLachlan
Jul 24, 2010·International Journal of Clinical Pharmacology and Therapeutics·J L SánchezJ M Cornejo-Bravo
Sep 8, 2010·The Journal of Antimicrobial Chemotherapy·Kichan DohDong-Seok Yim
Feb 23, 2011·Seminars in Dialysis·Stefaan J Vandecasteele, An S De Vriese
Jun 1, 2011·Journal of Pharmacokinetics and Pharmacodynamics·Xu Steven XuAn Vermeulen
Dec 14, 2011·Clinical Pharmacokinetics·Amélie MarsotNicolas Simon
May 11, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Sheryl A ZelenitskyLavern M Vercaigne

Citations

Mar 22, 2019·Pharmacotherapy·Robert C McLeay
Aug 14, 2020·The Journal of Antimicrobial Chemotherapy·Rashmi V ShingdeSophie L Stocker
Feb 6, 2020·Clinical Pharmacokinetics·Abdullah AljutayliFahima Nekka
Sep 19, 2020·Therapeutic Drug Monitoring·Siriluk JaisuePakawadee Sermsappasuk
Apr 1, 2021·British Journal of Clinical Pharmacology·Stephanie A RoydhouseSophie L Stocker

Related Concepts

Teens
Hemodialysis
Hospitalization
Retrospective Studies
AB-Vancomycin
Therapeutic Drug Monitoring
Academic Medical Centers
Blood
Creatinine
Vancomycin

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Lipidomics & Rhinovirus Infection

Lipidomics can be used to examine the lipid species involved with pathogenic conditions, such as viral associated inflammation. Discovered the latest research on Lipidomics & Rhinovirus Infection.

Spatio-Temporal Regulation of DNA Repair

DNA repair is a complex process regulated by several different classes of enzymes, including ligases, endonucleases, and polymerases. This feed focuses on the spatial and temporal regulation that accompanies DNA damage signaling and repair enzymes and processes.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Torsion Dystonia

Torsion dystonia is a movement disorder characterized by loss of control of voluntary movements appearing as sustained muscle contractions and/or abnormal postures. Here is the latest research.

Archaeal RNA Polymerase

Archaeal RNA polymerases are most similar to eukaryotic RNA polymerase II but require the support of only two archaeal general transcription factors, TBP (TATA-box binding protein) and TFB (archaeal homologue of the eukaryotic general transcription factor TFIIB) to initiate basal transcription. Here is the latest research on archaeal RNA polymerases.

Alzheimer's Disease: MS4A

Variants within the membrane-spanning 4-domains subfamily A (MS4A) gene cluster have recently been implicated in Alzheimer's disease in genome-wide association studies. Here is the latest research on Alzheimer's disease and MS4A.

Central Pontine Myelinolysis

Central Pontine Myelinolysis is a neurologic disorder caused most frequently by rapid correction of hyponatremia and is characterized by demyelination that affects the central portion of the base of the pons. Here is the latest research on this disease.