This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Vancomycin-Calculator.com is an open-access vancomycin dosing website that was developed using the Bauer PK method. Compared with three other websites, PK calculations resulted in significant differences for underweight and obese patients.
The objective of this project was to compare the time from initiation of oral anticoagulation to hospital discharge between warfarin and direct oral anticoagulants (DOACs) for the treatment of acute venous thromboembolism (VTE). This retrospective observational study was done at a single VA medical center. A total of 107 patients were included, with 42 patients (39%) in the DOAC group, which included rivaroxaban, dabigatran, and apixaban, and 65 patients (61%) in the warfarin group. Variables collected through chart review included comorbid conditions, time from initiation of oral anticoagulation to discharge, emergency department (ED) visits and readmission within 30 or 90 days, and bleeding events. The DOAC group had a shorter time to discharge compared to the warfarin group (28 vs. 114 h, p < 0.001). There were similar 30 and 90-day hospital readmission rates and/or ED visits for DOACs (23.8 and 33.3%) compared to warfarin (18.5 and 30.8%), including those related to bleeding of any severity (11.9% for DOACs vs. 9.2% for warfarin; p = 0.75). There was one major bleeding event in the DOAC group and two in the warfarin group. The use of DOACs for the treatment of acute VTE in hospitalized patients was associated with shorter time to hospital discharge when compared to warfarin.
Disclaimer In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose The purpose of this study was to evaluate the accuracy and precision of estimating area under the curve (AUC) values using only vancomycin trough concentrations versus both peak and trough values derived from applying 4 different volume of distribution (Vd) models in a veteran population. Methods This retrospective, observational study was performed from July 2021 to April 2022 using data from 5 Veterans Affairs hospitals across the US. AUC values for a total of 299 veterans were included in the analysis, with 10 excluded after pooling of data. Trough-only AUC values were calculated with 1-compartment intermittent infusion equations (Sawchuk-Zaske equations) using age- and weight-adjusted Vd values derived from an online calculator (VancoPK) or fixed Vd values specified by 3 comparator models. Results The mean population peak-trough AUC was 496 (range, 266-886). Of the 4 Vd models evaluated, the VancoPK model was the most accurate and precise, yielding a mean trough-only AUC of 491, with a correlation of 0.925; the root mean square error was 41, meaning that approximately 95% of the trough-only AUCs were within 82 points of values calculated using AUC peak-trough couplets. Conclusion A trough-only AUC estimation approach has many advantages over a peak-trough approach. The equation Vd = 0.29 (age in y) + 0.33 (actual BW in kg) + 11 provided accurate and precise AUC estimates with trough-only data when applied to pharmacokinetic equations in a veteran population.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.