Influence of renal function estimation on pharmacokinetic modeling of vancomycin in elderly patients

Antimicrobial Agents and Chemotherapy
Anaïs GlatardSylvain Goutelle

Abstract

Vancomycin is a renally excreted drug, and its body clearance correlates with creatinine clearance. However, the renal function estimation equation that best predicts vancomycin clearance has not been established yet. The objective of this study was to compare the abilities of different renal function estimation equations to describe vancomycin pharmacokinetics in elderly patients. The NPAG algorithm was used to perform population pharmacokinetic analysis of vancomycin concentrations in 78 elderly patients. Six pharmacokinetic models of vancomycin clearance were built, based on the following equations: Cockcroft-Gault (CG), Jelliffe (JEL), Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) (both in milliliters per minute per 1.73 m(2)), and modified MDRD and CKD-EPI equations (both in milliliters per minute). Goodness-of-fit and predictive performances of the six PK models were compared in a learning set (58 subjects) and a validation set (20 patients). Final analysis was performed to estimate population parameters in the entire population. In the learning step, the MDRD-based model best described the data, but the CG- and JEL-based models were the least biased. The mean we...Continue Reading

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Citations

Sep 27, 2018·Expert Opinion on Drug Metabolism & Toxicology·Federico Pea
Jul 15, 2020·Antibiotics·Iris H Chen, David P Nicolau
Jun 27, 2019·Expert Review of Clinical Pharmacology·Eva María Sáez FernándezAna Martín-Suárez
Jun 18, 2021·Clinical Pharmacology and Therapeutics·Sami UllahMax Taubert

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