Kimura Hiroshi, Shigematsu Marie, Tanaka Akihiro, Watanabe Shinichi, Takatori Shingo, Tanaka Mamoru, Mizuma Takashi, Araki Hiroaki
*Division of Pharmacy, Ehime University Hospital, Ehime, Japan; and †Department of Pharmaceutics, College of Pharmaceutical Sciences, Matsuyama University, Ehime, Japan.
Ther Drug Monit. 2017 Dec;39(6):614-616. doi: 10.1097/FTD.0000000000000454.
The performance of a population pharmacokinetic model in predicting trough concentrations after the initial vancomycin dose was evaluated in patients with albuminuria compared with patients who did not have albuminuria.
Data were collected from 52 patients infected with methicillin-resistant Staphylococcus aureus (excluding patients undergoing dialysis and acute kidney injury) and treated with vancomycin. The data included urinary albumin concentration.
The calculated mean prediction error and mean absolute error for the serum trough concentrations of vancomycin (with 95% confidence intervals) were 4.65 (4.13-5.17) and 6.1 (5.65-6.51), respectively, in microalbuminuria and 0.33 (-0.2 to 0.86) and 4.02 (3.59-4.45), respectively, in those without. There was no significant difference observed in serum creatinine concentration, age, weight, estimation of vancomycin trough concentration in serum, and actual trough concentration of vancomycin in serum between individuals with microalbuminuria and those without albuminuria.
Microalbuminuria in patients with diabetes is a marker of the difference between predicted vancomycin trough concentrations and actual vancomycin trough concentrations.
在有蛋白尿的患者与无蛋白尿的患者中，评估群体药代动力学模型预测初始万古霉素剂量后谷浓度的性能。
收集了52例耐甲氧西林金黄色葡萄球菌感染患者（不包括接受透析和急性肾损伤的患者）使用万古霉素治疗的数据。数据包括尿白蛋白浓度。
在微量白蛋白尿患者中，万古霉素血清谷浓度的计算平均预测误差和平均绝对误差（95%置信区间）分别为4.65（4.13 - 5.17）和6.1（5.65 - 6.51），在无微量白蛋白尿的患者中分别为0.33（-0.2至0.86）和4.02（3.59 - 4.45）。微量白蛋白尿患者与无蛋白尿患者在血清肌酐浓度、年龄、体重、血清万古霉素谷浓度估计值以及血清万古霉素实际谷浓度方面未观察到显著差异。
糖尿病患者的微量白蛋白尿是预测的万古霉素谷浓度与实际万古霉素谷浓度差异的一个标志。
