Development and evaluation of a vancomycin dosing nomogram to achieve the target area under the concentration-time curve. A retrospective study
Development and evaluation of a vancomycin dosing nomogram to achieve the target area under the concentration-time curve. A retrospective study
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DOI：
10.1016/j.jiac.2019.11.009
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发表时间：
2020-05-01
影响因子：
2.2
通讯作者：
Saito, Hideyuki
中科院分区：
文献类型：
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作者：
Oda, Kazutaka;Katanoda, Tomomi;Saito, Hideyuki
尽管已报告基于浓度-时间曲线下面积（AUC（0-24））的万古霉素给药优于基于谷浓度的给药，但尚未开发达到目标AUC（0-24）的给药策略。本研究的目的是开发一种方便可用的万古霉素给药诺模图，以获得目标AUC（0-24）（400 μ g h/mL）。诺模图是以回顾性方式进行药代动力学开发的。用于绘制列线图的入组患者数量和浓度分别为166例和309例，用于评价列线图的入组患者数量和浓度分别为99例和181例。将列线图绘制为对应于估计肾小球滤过率（eGFR）各范围的剂量/个人体重，通过非线性混合效应模型确定eGFR为万古霉素清除率的协变量。诺模图描述了目标AUC（0-24）的替代谷浓度，计算结果与每个eGFR范围（9.3-15.0 μ g/mL）不同。在评价期间，使用替代谷浓度获得目标AUC（0-24）的治疗范围达到率为63.8%。我们开发并评价了第一个方便可用的万古霉素给药诺模图，以获得目标AUC（0-24）。(c)2019年日本化疗学会和日本传染病协会。由爱思唯尔有限公司出版。保留所有权利。
Although the superiority of vancomycin dosing based on area under the concentration-time curve (AUC(0-24)) over that based on trough concentration has been reported, a dosing strategy to achieve the target AUC(0-24) has yet to be developed. The objective of this study was to develop a convenient useable nomogram for vancomycin dosing to obtain the target AUC(0-24) (400 mu g h/mL). The nomogram was pharmacokinetically developed in a retrospective manner. The number of enrolled patients and concentrations was 166 and 309 for development of the nomogram, 99 and 181 for evaluation of the nomogram, respectively. The nomogram was developed as doses per personal body weight corresponding to each range of estimated glomerular filtration rate (eGFR), which was identified to be the covariate for vancomycin clearance by non-linear mixed effect modeling. The nomogram described the surrogate trough concentration for the target AUC(0-24) was calculatedly different for each eGFR range (9.3-15.0 mu g/mL). The rate of attainment of therapeutic range using surrogate trough concentration to obtain the target AUC(0-24) was 63.8% in the evaluation period. We have developed and evaluated the first convenient useable nomogram of vancomycin dosing to obtain the target AUC(0-24). (c) 2019 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.