Pai Manjunath P, Hong Joseph, Krop Lynne
Department of Clinical Pharmacy, College of Pharmacy, University of Michigan, Ann Arbor, Michigan, USA
Morton Plant Hospital, BayCare Health System, Clearwater, Florida, USA.
Antimicrob Agents Chemother. 2017 Mar 24;61(4). doi: 10.1128/AAC.02490-16. Print 2017 Apr.
Vancomycin area under the curve (AUC) estimates may be skewed in obese adults due to weight-dependent pharmacokinetic parameters. We demonstrate that peak and trough measurements reduce bias and improve the precision of vancomycin AUC estimates in obese adults ( = 75) and validate this in an independent cohort ( = 31). The precision and mean percent bias of Bayesian vancomycin AUC estimates are comparable between covariate-dependent ( = 0.774, 3.55%) and covariate-independent ( = 0.804, 3.28%) models when peaks and troughs are measured but not when measurements are restricted to troughs only ( = 0.557, 15.5%).
由于药代动力学参数依赖于体重，肥胖成年人的万古霉素曲线下面积（AUC）估计值可能会有偏差。我们证明，在肥胖成年人（n = 75）中，峰浓度和谷浓度测量可减少偏差并提高万古霉素AUC估计的精度，并在一个独立队列（n = 31）中进行了验证。当测量峰浓度和谷浓度时，贝叶斯万古霉素AUC估计值的精度和平均偏差百分比在依赖协变量（n = 0.774，3.55%）和不依赖协变量（n = 0.804，3.28%）的模型之间具有可比性，但仅测量谷浓度时则不然（n = 0.557，15.5%）。
