Development of Vancomycin Dose Individualization Strategy by Bayesian Prediction in Patients Receiving Continuous Renal Replacement Therapy

Oda, Kazutaka; Jono, Hirofumi; Kamohara, Hidenobu; Nishi, Kazuhiko; Tanoue, Naomi; Saya, Hideyuki

doi:10.1007/s11095-020-02820-0

Cited by 14 publications

(19 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“… Better prior probability was reported in a population PK model based on rich sampling (full data set: e.g., at the end of infusion, at 60, 120, and 300 min following the infusion, and immediately before the next dose) than that based on limited sampling (e.g., trough and peak concentrations) [ 66 , 67 , 68 , 69 , 70 , 71 ]. Population properties (i.e., age, body weight, kidney function, other potential covariates) for establishing a population PK model should be considered to determine the reasonable candidates for the MIPD software to increase the accuracy of dosing [ 53 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 ]. The Bayesian prior information has been accumulated in special populations of obesity, paediatrics, and renal replacement therapy (RRT).…”

Section: Resultsmentioning

confidence: 99%

“…Population properties (i.e., age, body weight, kidney function, other potential covariates) for establishing a population PK model should be considered to determine the reasonable candidates for the MIPD software to increase the accuracy of dosing [ 53 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 ].…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…The predictive performance of Bayesian posterior AUC is limited in patients receiving RRT, although the Bayesian prior information has accumulating [ 61 , 79 , 80 , 81 , 82 , 83 ]. Oda et al reported an external evaluation study of a population PK model for patients receiving continuous RRT (CRRT) [ 82 ]. The target (trough concentration of 10–20 μg/mL) attainment rate in patients who underwent dose titration using Bayesian prediction was 87.0% (20/23), which was significantly higher than that of 53.8% (7/13, p = 0.046) achieved using traditional TDM (using creatinine clearance).…”

Section: Discussionmentioning

confidence: 99%

“…The target (trough concentration of 10–20 μg/mL) attainment rate in patients who underwent dose titration using Bayesian prediction was 87.0% (20/23), which was significantly higher than that of 53.8% (7/13, p = 0.046) achieved using traditional TDM (using creatinine clearance). The software based on Visual Basic for Applications was developed for patients receiving CRRT [ 82 ].…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Clinical Practice Guidelines for Therapeutic Drug Monitoring of Vancomycin in the Framework of Model-Informed Precision Dosing: A Consensus Review by the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background: To promote model-informed precision dosing (MIPD) for vancomycin (VCM), we developed statements for therapeutic drug monitoring (TDM). Methods: Ten clinical questions were selected. The committee conducted a systematic review and meta-analysis as well as clinical studies to establish recommendations for area under the concentration-time curve (AUC)-guided dosing. Results: AUC-guided dosing tended to more strongly decrease the risk of acute kidney injury (AKI) than trough-guided dosing, and a lower risk of treatment failure was demonstrated for higher AUC/minimum inhibitory concentration (MIC) ratios (cut-off of 400). Higher AUCs (cut-off of 600 μg·h/mL) significantly increased the risk of AKI. Although Bayesian estimation with two-point measurement was recommended, the trough concentration alone may be used in patients with mild infections in whom VCM was administered with q12h. To increase the concentration on days 1–2, the routine use of a loading dose is required. TDM on day 2 before steady state is reached should be considered to optimize the dose in patients with serious infections and a high risk of AKI. Conclusions: These VCM TDM guidelines provide recommendations based on MIPD to increase treatment response while preventing adverse effects.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Clinical Practice Guidelines for Therapeutic Drug Monitoring of Vancomycin in the Framework of Model-Informed Precision Dosing: A Consensus Review by the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

Practical considerations for individualizing drug dosing in critically ill adults receiving renal replacement therapy

et al. 2023

View full text Add to dashboard Cite

Critically ill patients with sepsis admitted to the intensive care unit (ICU) often present with or develop renal dysfunction requiring renal replacement therapy (RRT) in addition to antimicrobial therapy. While early and appropriate antimicrobials for sepsis have been associated with an increased probability of survival, adequate dosing is also required in these patients. Adequate dosing of antimicrobials refers to dosing strategies that achieve serum drug levels at the site of infection that are able to provide a microbiological and/or clinical response while avoiding toxicity from excessive antibiotic exposure. Therapeutic drug monitoring (TDM) is the recommended strategy to achieve this goal, however, TDM is not routinely available in all ICUs and for all antimicrobials. In the absence of TDM, clinicians are therefore required to make dosing decisions based on the clinical condition of the patient, the causative organism, the characteristics of RRT, and an understanding of the physicochemical properties of the antimicrobial. Pharmacokinetics (PK) of antimicrobials can be highly variable between critically ill patients and also within the same patient over the course of their ICU stay. The initiation of RRT, which can be in the form of intermittent hemodialysis, continuous, or prolonged intermittent therapy, further complicates the predictability of drug disposition. This variability highlights the need for individualized dosing. This review highlights the practical considerations for the clinician for antimicrobial dosing in critically ill patients receiving RRT.

show abstract

Critical assessment of the revised guidelines for vancomycin therapeutic drug monitoring

Aljutayli¹,

Thirion²,

Nekka³

2022

Biomedicine & Pharmacotherapy

View full text Add to dashboard Cite

Development of Vancomycin Dose Individualization Strategy by Bayesian Prediction in Patients Receiving Continuous Renal Replacement Therapy

Cited by 14 publications

References 37 publications

Clinical Practice Guidelines for Therapeutic Drug Monitoring of Vancomycin in the Framework of Model-Informed Precision Dosing: A Consensus Review by the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring

Clinical Practice Guidelines for Therapeutic Drug Monitoring of Vancomycin in the Framework of Model-Informed Precision Dosing: A Consensus Review by the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring

Practical considerations for individualizing drug dosing in critically ill adults receiving renal replacement therapy

Critical assessment of the revised guidelines for vancomycin therapeutic drug monitoring

Contact Info

Product

Resources

About