Population pharmacokinetics of vancomycin in Chinese elderly patients and its application for dose individualisation

作     者：Jin Zhang Weiwei Lin Wei Wu Xianzhong Guo Pinfang Huang Xinhua Lin Zheng Jiao Changlian Wang 张金;林玮玮;吴委;郭仙忠;黄品芳;林新华;焦正;王长连

作者机构：Department of PharmacyThe First Affiliated HospitalFujian Medical UniversityFuzhou 350005FujianChina Department of PharmacyUnion HospitalFujian Medical UniversityFuzhou 350001FujianChina Department of PharmacyShanghai Chest HospitalShanghai Jiaotong UniversityShanghai 200030China The School of PharmacyFujian Medical UniversityFuzhou 350108FujianChina 

基　　金：Guidance Project of Fujian Science and Technology Department(Grant No.2017Y0033) Fujian Medical Innovation Project(Grant No.2017-CX-31) Sail Project of Fujian Medical University(Grant No.2017XQ1068) “Weak Discipline Construction Project” of Shanghai Municipal Commission of Health and Family Planning(Grant No.2016ZB0301-01) 

出 版 物：《Journal of Chinese Pharmaceutical Sciences》 (中国药学（英文版）)

年 卷 期：2020年第29卷第4期

页      码：260-271页

摘      要：In the present study, we aimed to develop a population pharmacokinetics(PPK) model of vancomycin(VCM) and propose the individualised dosage regimen for Chinese elderly patients. The data were collected prospectively from Chinese elderly patients receiving VCM therapy. Steady-state trough concentrations of VCM were determined using an enzyme-multiplied immunoassay. Patients’ sex, age, body weight, concomitant medications, infection type, and laboratory findings were recorded. The PPK model was developed using nonlinear mixed-effects model software. Moreover, we used Monte Carlo simulations to develop an initial dosage regimen targeting various VCM through concentration ranges based on the final model. We found that VCM clearance(CL) was significantly influenced by post-craniotomy meningitis(PCM) and glomerular filtration rate in elderly patients. Additionally, a new dosage regimen was proposed to individualise VCM regimen for PCM and non-PCM elderly patients. A PPK model was established to estimate the individual VCM CL for elderly patients, which could be applied for individualising doses in the target population.

主 题 词：Elderly patient Population pharmacokinetics Post-craniotomy meningitis Vancomycin Dose individualisation 

学科分类：100702[100702] 1007[医学-药学类] 1006[医学-中西医结合类] 100602[100602] 10[医学] 

核心收录：

D　O　I：10.5246/jcps.2020.04.025

馆 藏 号：203907088...