Amador Jorge S, Vega Álvaro, Araos Patricio, Quiñones Luis A, Amador Cristián A
Intensive Care Unit, San Borja Arriarán Clinical Hospital, Santiago 8360160, Chile.
School of Chemistry and Pharmacy, Faculty of Medicine, Universidad Andrés Bello, Santiago 8320000, Chile.
Pharmaceuticals (Basel). 2025 May 2;18(5):677. doi: 10.3390/ph18050677.
Vancomycin, a hydrophilic glycopeptide antibiotic with bactericidal activity against Gram-positive microorganisms, is one of the most commonly used antibiotics un the intensive care unit (ICU). Different efforts have been made to achieve a therapeutically effective plasma concentration of vancomycin by using loading and subsequent maintenance doses on an individual basis, but this remains subject to debate. Our objective was to individualize a dosage regimen in a Chilean ICU to optimize the pharmacological treatment of vancomycin by using a population pharmacokinetic model. : A quantitative descriptive study was carried out in 51 patients at the adult ICU, San Borja Arriarán Clinical Hospital in Santiago, Chile. The dose of vancomycin was calculated by using a population pharmacokinetic software, the Antibiotic Kinetics, and was subsequently validated with plasma trough levels of the drug through a patient sample. : The most commonly prescribed loading dose was 1500 mg and the most commonly used maintenance dose was 1000 mg, three times a day. The measured blood plasma concentrations of each patient (16.98 ± 5.423 μg/mL) were compared with the concentrations calculated through the population pharmacokinetic model (14.33 ± 4.630 μg/mL, < 0.05). In addition, a correlation was found between the software-calculated trough concentration versus the measured trough concentration for vancomycin, with a positive correlation between both variables established (R = 0.65; < 0.0001). No renal side effects were observed in the treated patient group. : In the present study, a vancomycin dosing model for critically ill patients, based on a population pharmacokinetic model, was successfully implemented for routine clinical practice.
万古霉素是一种对革兰氏阳性微生物具有杀菌活性的亲水性糖肽类抗生素，是重症监护病房（ICU）中最常用的抗生素之一。人们已经做出了各种努力，通过个体化给予负荷剂量和后续维持剂量来达到治疗有效的万古霉素血药浓度，但这一做法仍存在争议。我们的目标是利用群体药代动力学模型，在智利的一家ICU中制定个体化给药方案，以优化万古霉素的药物治疗。：在智利圣地亚哥圣博尔哈·阿里亚兰临床医院的成人ICU对51例患者进行了定量描述性研究。万古霉素的剂量通过群体药代动力学软件“抗生素动力学”计算得出，随后通过患者样本的药物血浆谷浓度进行验证。：最常开具的负荷剂量为1500mg，最常用的维持剂量为1000mg，每日三次。将每位患者测得的血浆浓度（16.98±5.423μg/mL）与通过群体药代动力学模型计算得出的浓度（14.33±4.630μg/mL，P<0.05）进行比较。此外，发现万古霉素软件计算的谷浓度与测得的谷浓度之间存在相关性，两个变量之间呈正相关（R=0.65；P<0.0001）。在接受治疗的患者组中未观察到肾脏副作用。：在本研究中，基于群体药代动力学模型的危重症患者万古霉素给药模型已成功应用于常规临床实践。
