Document Detail


Vancomycin pharmacokinetics and Bayesian estimation in pediatric patients.
MedLine Citation:
PMID:  11034256     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The vancomycin pharmacokinetic profile was characterized in six pediatric patients and the potential of nonlinear mixed effects modeling and Bayesian forecasting for vancomycin monitoring was explored using NONMEM V (1.1). Based on steady state serial vancomycin concentrations, the estimates of mean t1/2, Vd, and Cl derived by the Sawchuk and Zaske method (1) were 3.52 hours, 0.57 L/kg, and 0.12 L/h per kg, respectively. NONMEM analysis demonstrated that a weight-adjusted two-compartment model described individual patients' data better than a comparable one-compartment model. The two-compartment estimates of mean t1/2alpha, t1/2beta, Vss, and Cl were 0.80 hour, 5.63 hours, 0.63 L/kg, and 0.11 L/h per kg, respectively. The relatively long mean t1/2alpha suggests that peak vancomycin concentrations measured earlier than 4 hours postdose do not reflect postdistributional serum concentrations. NONMEM population modeling revealed that a weight-adjusted two-compartment model provided a better fit than a comparable one-compartment model. The resulting population parameters and variances were fixed in NONMEM to obtain Bayesian predictions of individual vancomycin serum concentrations. Bayesian estimation with either a single midinterval or trough sample has the potential to provide accurate and precise predictions of vancomycin concentrations. This should be evaluated using a vancomycin population pharmacokinetic model based on a larger sample of pediatric patients.
Authors:
R E Wrishko; M Levine; D Khoo; P Abbott; D Hamilton
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Therapeutic drug monitoring     Volume:  22     ISSN:  0163-4356     ISO Abbreviation:  Ther Drug Monit     Publication Date:  2000 Oct 
Date Detail:
Created Date:  2001-01-17     Completed Date:  2001-03-08     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  7909660     Medline TA:  Ther Drug Monit     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  522-31     Citation Subset:  IM    
Affiliation:
Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada.
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MeSH Terms
Descriptor/Qualifier:
Anti-Bacterial Agents / pharmacokinetics*
Bayes Theorem
Child
Child, Preschool
Cohort Studies
Drug Monitoring* / methods
Female
Humans
Male
Vancomycin / pharmacokinetics*
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 1404-90-6/Vancomycin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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