dc.contributor.author | Heffernan, AJ | |
dc.contributor.author | Germano, A | |
dc.contributor.author | Sime, FB | |
dc.contributor.author | Roberts, Jason A | |
dc.contributor.author | Kimura, E | |
dc.date.accessioned | 2019-09-02T00:57:06Z | |
dc.date.available | 2019-09-02T00:57:06Z | |
dc.date.issued | 2019 | |
dc.identifier.issn | 0031-6970 | |
dc.identifier.doi | 10.1007/s00228-019-02694-1 | |
dc.identifier.uri | http://hdl.handle.net/10072/386833 | |
dc.description.abstract | Purpose:
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.peerreviewed | Yes | |
dc.language | English | |
dc.language.iso | eng | |
dc.publisher | Springer Science and Business Media LLC | |
dc.relation.ispartofpagefrom | 1219 | |
dc.relation.ispartofpageto | 1226 | |
dc.relation.ispartofissue | 9 | |
dc.relation.ispartofjournal | European Journal of Clinical Pharmacology | |
dc.relation.ispartofvolume | 75 | |
dc.subject.fieldofresearch | Pharmacology and pharmaceutical sciences | |
dc.subject.fieldofresearchcode | 3214 | |
dc.subject.keywords | Pharmacokinetics | |
dc.subject.keywords | Sepsis | |
dc.subject.keywords | Septic shock | |
dc.subject.keywords | Therapeutic drug monitoring | |
dc.subject.keywords | Vancomycin | |
dc.title | Vancomycin population pharmacokinetics for adult patients with sepsis or septic shock: are current dosing regimens sufficient? | |
dc.type | Journal article | |
dc.type.description | C1 - Articles | |
dcterms.bibliographicCitation | Heffernan, 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.dateAccepted | 2019-05-14 | |
dc.date.updated | 2019-08-31T19:34:42Z | |
gro.hasfulltext | No Full Text | |
gro.griffith.author | Heffernan, Aaron J. | |