Mahmoud M A, Ebid A H I M, Shouman Samia A, Ebid Emad N
Department of Pharmacy Practice, College of Pharmacy, Helwan University, Cairo, Egypt.
Department of Clinical Biochemistry, National Cancer Institute, Cairo University, Cairo, Egypt.
Indian J Pharm Sci. 2014 Jan;76(1):82-6.
The purpose of this study is to determine the pharmacokinetic parameters of vancomycin in Egyptian paediatric oncology patients and to evaluate the factors that influence the variability of the pharmacokinetic parameters in this population. Vancomycin serum concentration at steady state was determined in 51 paediatric cancer patients who were treated with vancomycin multiple intravenous infusions. Also individual vancomycin pharmacokinetic parameters were calculated assuming one compartment model. The mean vancomycin total body clearance and mean vancomycin volume of distribution were significantly higher among the age range of 2 to <12 years as compared with older age. Obese patients showed significant lower values of peak and trough vancomycin concentrations than those of normal and underweight patients. A significant correlation was found between the estimated creatinine clearance (Schwartz formula) and vancomycin total body clearance in the studied patients. Also, a significant direct correlation between vancomycin volume of distribution and ratio between blood urea nitrogen (mg/dl)/weight (kg) was found. As a conclusion, age and obesity were identified as the most important factors influencing vancomycin total body clearance, volume of distribution and serum concentrations in the studied patients.
本研究的目的是确定万古霉素在埃及儿科肿瘤患者中的药代动力学参数，并评估影响该人群药代动力学参数变异性的因素。对51例接受多次万古霉素静脉输注治疗的儿科癌症患者测定了稳态时的万古霉素血清浓度。同时假设为一室模型计算了个体万古霉素药代动力学参数。与年龄较大的患者相比，2至<12岁年龄组的万古霉素总体清除率均值和万古霉素分布容积均值显著更高。肥胖患者的万古霉素峰浓度和谷浓度值显著低于正常和体重不足患者。在所研究的患者中，估计的肌酐清除率（施瓦茨公式）与万古霉素总体清除率之间存在显著相关性。此外，还发现万古霉素分布容积与血尿素氮（mg/dl）/体重（kg）之比之间存在显著的直接相关性。结论是，年龄和肥胖被确定为影响所研究患者万古霉素总体清除率、分布容积和血清浓度的最重要因素。
