Kim Yong Kyun, Kim Doy, Kang Gaeun, Zang Dae Young, Lee Dong-Hwan
Division of Infectious Diseases, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14066, Republic of Korea.
Department of Medicine, Hallym University College of Medicine, Chuncheon 24252, Republic of Korea.
Antibiotics (Basel). 2024 Oct 19;13(10):993. doi: 10.3390/antibiotics13100993.
: To date, population pharmacokinetic (PK) studies of vancomycin on healthy Korean adults have not been conducted. This study aimed to investigate the PK properties of vancomycin in healthy volunteers and to identify optimal dosing regimens based on the area under the concentration-time curve (AUC) in adult patients with normal renal function. : We conducted a prospective clinical study, analysing PK samples from 12 healthy participants using noncompartmental analysis and non-linear mixed-effects modelling. The population PK parameters derived were employed in Monte Carlo simulations to evaluate the adequacy of the current dosing regimen and to formulate dosing recommendations. : The PK profiles were optimally described by a two-compartment model, with body weight and age as significant covariates affecting total clearance. The simulations indicated that to achieve a therapeutic target-defined as an AUC at steady-state over 24 h of 400-600 mg·h/L-daily doses ranging from 60 to 70 mg/kg are necessary in adults with normal renal function. : This study underscores the need to actively adjust dosage and administration based on a vancomycin PK model that adequately reflects the demographic characteristics of patients to meet both safety and efficacy standards.
迄今为止,尚未对健康韩国成年人进行万古霉素的群体药代动力学(PK)研究。本研究旨在调查健康志愿者中万古霉素的PK特性,并根据肾功能正常的成年患者的浓度-时间曲线下面积(AUC)确定最佳给药方案。我们进行了一项前瞻性临床研究,使用非房室分析和非线性混合效应模型分析了12名健康参与者的PK样本。推导得到的群体PK参数用于蒙特卡洛模拟,以评估当前给药方案的 adequacy 并制定给药建议。PK曲线由二室模型最佳描述,体重和年龄是影响总清除率的重要协变量。模拟表明,为达到治疗目标(定义为稳态下24小时AUC为400 - 600mg·h/L),肾功能正常的成年人每日剂量范围为60至70mg/kg是必要的。本研究强调需要基于充分反映患者人口统计学特征的万古霉素PK模型积极调整剂量和给药方式,以满足安全性和有效性标准。