Predictive performance of reported population pharmacokinetic models of vancomycin in Chinese adult patients

Deng, Chonghai; Liu, T.; K, Wu; Wang, S.; Li, L.; Liu, Hua; Zhou, Tianyan; Cheng, Dao-Hai; Zhong, Xin; Lu, Wei

doi:10.1111/jcpt.12092

Cited by 24 publications

(23 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similar findings were reported in a previous study that if only a single sample was utilized, Bayesian predicted concentrations were less accurate when obtained using the first ('oldest') observed concentration compared with the most recent observed vancomycin concentration (14). By contrast, in the general patient population, it was reported that taking more TDM data into account did improve the performance of Bayesian forecasting for vancomycin (15).…”

Section: Discussionsupporting

confidence: 87%

Optimizing Predictive Performance of Bayesian Forecasting for Vancomycin Concentration in Intensive Care Patients

et al. 2020

View full text Add to dashboard Cite

Purpose Bayesian forecasting is crucial for model-based dose optimization based on therapeutic drug monitoring (TDM) data of vancomycin in intensive care (ICU) patients. We aimed to evaluate the performance of Bayesian forecasting using maximum a posteriori (MAP) estimation for model-based TDM. Methods We used a vancomycin TDM data set (n = 408 patients). We compared standard MAP-based Bayesian forecasting with two alternative approaches: (i) adaptive MAP which handles data over multiple iterations, and (ii) weighted MAP which weights the likelihood contribution of data. We evaluated the percentage error (PE) for seven scenarios including historical TDM data from the preceding day up to seven days. Results The mean of median PEs of all scenarios for the standard MAP, adaptive MAP and weighted MAP method were − 7.7%, −4.5% and − 6.7%. The adaptive MAP also showed the narrowest inter-quartile range of PE. In addition, regardless of MAP method, including historical TDM data further in the past will increase prediction errors. Conclusions The proposed adaptive MAP method outperforms standard MAP in predictive performance and may be considered for improvement of model-based dose optimization. The inclusion of historical data beyond either one day (standard MAP and weighted MAP) or two days (adaptive MAP) reduces predictive performance.

show abstract

Section: Discussionsupporting

confidence: 87%

Optimizing Predictive Performance of Bayesian Forecasting for Vancomycin Concentration in Intensive Care Patients

et al. 2020

View full text Add to dashboard Cite

show abstract

“…It is known that external validation of existing models with own data does not always result in good performance and usefulness of the existing models (18).…”

Section: Discussionmentioning

confidence: 99%

Population Pharmacokinetics and Dosing Considerations for Gentamicin in Newborns with Suspected or Proven Sepsis Caused by Gram-Negative Bacteria

Bijleveld

Heuvel

Hodiamont

et al. 2017

Antimicrob Agents Chemother

View full text Add to dashboard Cite

The aim of this study was to describe the population pharmacokinetics (PK) of gentamicin in neonates with suspected or proven Gram-negative sepsis and determine the optimal dosage regimen in relation to the bacterial MICs found in this population. Data were prospectively collected between October 2012 and January 2013 in the Neonatal Intensive Care Unit (NICU) at the Academic Medical Center (AMC), Amsterdam, The Netherlands. A single nonlinear mixed-effects regression analysis (NONMEM) was performed to describe the population PK of gentamicin. Dosage regimens based upon gestational age (GA) were generated using Monte Carlo simulations with the final model. Target values were based on the MIC distribution in our patient population. In total, 136 gentamicin concentrations from 65 (pre)term neonates were included. The PK was best described by an allometric 2-compartment model with postmenstrual age (PMA) as a covariate on clearance (Cl). The MIC distribution (median, 0.75 [range, 0.5 to 1.5] mg/liter) justified a gentamicin target peak concentration of 8 to 12 mg/liter. This study describes the PK of gentamicin in (pre)term neonates. Dosage regimens of 5 mg/kg of body weight every 48 h, 5 mg/kg every 36 h, and 5 mg/kg every 24 h for patients with GAs of Ͻ37 weeks, 37 to 40 weeks, and Ն40 weeks, respectively, are recommended.

show abstract

“…The maximum a posteriori Bayesian estimation method has already been used to support vancomycin dosing decisions in adults (Deng et al, 2013 ; Jacqz-Aigrain et al, 2015 ) and children (Le et al, 2014 ). To obtain accurate estimation with this method for individualized therapy, it is crucial that reliable population pharmacokinetic characteristics are known for the target patients.…”

Section: Introductionmentioning

confidence: 99%

Population Pharmacokinetics of Vancomycin in Chinese ICU Neonates: Initial Dosage Recommendations

Liu

Jiao

et al. 2018

Front. Pharmacol.

View full text Add to dashboard Cite

The main goal of our study was to characterize the population pharmacokinetics of vancomycin in critically ill Chinese neonates to develop a pharmacokinetic model and investigate factors that have significant influences on the pharmacokinetics of vancomycin in this population. The study population consisted of 80 neonates in the neonatal intensive care unit (ICU) from which 165 trough and peak concentrations of vancomycin were obtained. Nonlinear mixed effect modeling was used to develop a population pharmacokinetic model for vancomycin. The stability and predictive ability of the final model were evaluated based on diagnostic plots, normalized prediction distribution errors and the bootstrap method. Serum creatinine (Scr) and body weight were significant covariates on the clearance of vancomycin. The average clearance was 0.309 L/h for a neonate with Scr of 23.3 μmol/L and body weight of 2.9 kg. No obvious ethnic differences in the clearance of vancomycin were found relative to the earlier studies of Caucasian neonates. Moreover, the established model indicated that in patients with a greater renal clearance status, especially Scr < 15 μmol/L, current guideline recommendations would likely not achieve therapeutic area under the concentration-time curve over 24 h/minimum inhibitory concentration (AUC24h/MIC) ≥ 400. The exceptions to this are British National Formulary (2016–2017), Blue Book (2016) and Neofax (2017). Recommended dose regimens for neonates with different Scr levels and postmenstrual ages were estimated based on Monte Carlo simulations and the established model. These findings will be valuable for developing individualized dosage regimens in the neonatal ICU setting.

show abstract

Predictive performance of reported population pharmacokinetic models of vancomycin in Chinese adult patients

Cited by 24 publications

References 29 publications

Optimizing Predictive Performance of Bayesian Forecasting for Vancomycin Concentration in Intensive Care Patients

Optimizing Predictive Performance of Bayesian Forecasting for Vancomycin Concentration in Intensive Care Patients

Population Pharmacokinetics and Dosing Considerations for Gentamicin in Newborns with Suspected or Proven Sepsis Caused by Gram-Negative Bacteria

Population Pharmacokinetics of Vancomycin in Chinese ICU Neonates: Initial Dosage Recommendations

Contact Info

Product

Resources

About