Vancomycin Area Under the Curve Simplified

Therapeutic Drug Monitoring
Paul Lewis

Abstract

Serum trough concentrations as the sole means of monitoring safety and efficacy of vancomycin are insufficient. The daily area under the curve (AUC24) of serum concentration versus time to minimum inhibitory concentration (MIC) ratio of greater than 400 mg × h/L has emerged as a more robust dosing target. A simple and practical method to extrapolate AUC24 from troughs is needed. This mathematical model computes the median and range AUC24 using the dose in mg/kg and the observed serum trough concentration. AUC24 is calculated using dose in mg/kg divided by the volume of distribution (Vd) and elimination constant (Ke). Vd is provided using the population median (range) of 0.7 (0.4-1) L/kg. Ke is calculated using the trough and population Vd. For doses of 15-20 mg/kg, troughs of at least 11 mg/L will achieve AUC24 of greater than 400 mg × h/L, even with a Vd of 1 L/kg. Using the median Vd and lower, AUC24 greater than 400 mg × h/L can be achieved with troughs as little as 9 mg/L using doses of 15 mg/kg and greater. The AUC24:MIC goal of greater than 400 can still be attained with an MIC of 1.5 mg/L by using doses of at least 15 mg/kg and targeting troughs of at least 16 mg/L for a patient with a Vd of 0.7 L/kg or less. Troughs of ...Continue Reading

References

Dec 25, 2008·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Michael RybakDonald P Levine
Jul 10, 2009·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Thomas P LodiseGeorge L Drusano
Jun 15, 2010·Diagnostic Microbiology and Infectious Disease·Elizabeth A NeunerPeggy S McKinnon
Jul 27, 2010·British Journal of Clinical Pharmacology·Natalia RevillaMaría Del Mar Fernández de Gatta
Sep 29, 2011·Antimicrobial Agents and Chemotherapy·John A BossoPatrick D Mauldin
Dec 14, 2011·Clinical Pharmacokinetics·Amélie MarsotNicolas Simon
Jun 10, 2014·Advanced Drug Delivery Reviews·Manjunath P PaiThomas P Lodise
Nov 1, 2017·Antimicrobial Agents and Chemotherapy·Evan J ZasowskiMichael J Rybak

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