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dc.contributor.authorHeffernan, AJ
dc.contributor.authorGermano, A
dc.contributor.authorSime, FB
dc.contributor.authorRoberts, Jason A
dc.contributor.authorKimura, E
dc.date.accessioned2019-09-02T00:57:06Z
dc.date.available2019-09-02T00:57:06Z
dc.date.issued2019
dc.identifier.issn0031-6970
dc.identifier.doi10.1007/s00228-019-02694-1
dc.identifier.urihttp://hdl.handle.net/10072/386833
dc.description.abstractPurpose: Vancomycin is commonly used for the management of severe infections; however, vancomycin dosing may be challenging in critically ill patients. This observational study aims to describe the population pharmacokinetics of vancomycin in adult patients with sepsis or septic shock. Methods: A single-centre retrospective review of adult patients with sepsis or septic shock receiving vancomycin with therapeutic drug monitoring was undertaken. Blood samples taken 1 h after the vancomycin infusion cessation and 30 min prior to the next dose were assayed using the Vitros Crea Slide method. Vancomycin concentrations determined on different days were included. A pharmacokinetic model was developed using Pmetrics for R. Monte Carlo dosing simulations were performed using the final model. Results: Vancomycin concentrations were available for 27 adult patients admitted to the intensive care unit with sepsis or septic shock. A one-compartment pharmacokinetic model with inter-occasion variability of clearance and volume of distribution before and after 72 h adequately described the data. Creatinine clearance normalized to body surface area was included as a covariate on vancomycin clearance. The clearance and volume of distribution within 72 h of admission were 7.29 L/h and 54.20 L, respectively. Monte Carlo simulations suggested that for patients with a creatinine clearance of ≥ 80 mL/min/1.73 m2, vancomycin doses of ≥ 2 g every 8 h are required to consistently achieve key therapeutic targets. Conclusions: Vancomycin doses ≥ 2 g every 8 h in adult patients with sepsis or septic shock with a creatinine clearance ≥ 80 mL/min/1.73 m2 are likely needed to achieve an optimal therapeutic exposure.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherSpringer Science and Business Media LLC
dc.relation.ispartofpagefrom1219
dc.relation.ispartofpageto1226
dc.relation.ispartofissue9
dc.relation.ispartofjournalEuropean Journal of Clinical Pharmacology
dc.relation.ispartofvolume75
dc.subject.fieldofresearchPharmacology and pharmaceutical sciences
dc.subject.fieldofresearchcode3214
dc.subject.keywordsPharmacokinetics
dc.subject.keywordsSepsis
dc.subject.keywordsSeptic shock
dc.subject.keywordsTherapeutic drug monitoring
dc.subject.keywordsVancomycin
dc.titleVancomycin population pharmacokinetics for adult patients with sepsis or septic shock: are current dosing regimens sufficient?
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationHeffernan, AJ; Germano, A; Sime, FB; Roberts, JA; Kimura, E, Vancomycin population pharmacokinetics for adult patients with sepsis or septic shock: are current dosing regimens sufficient?, European Journal of Clinical Pharmacology, 2019, 75 (9), pp. 1219-1226
dcterms.dateAccepted2019-05-14
dc.date.updated2019-08-31T19:34:42Z
gro.hasfulltextNo Full Text
gro.griffith.authorHeffernan, Aaron J.


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