Details

Autor(en) / Beteiligte

• Šíma, Martin
• Hartinger, Jan
• Grus, Tomáš
• Slanař, Ondřej

Titel

Initial dosing of intermittent vancomycin in adults: estimation of dosing interval in relation to dose and renal function

Ist Teil von

• European journal of hospital pharmacy. Science and practice, 2021-09, Vol.28 (5), p.276-279

Ort / Verlag

England: BMJ Publishing Group LTD

Erscheinungsjahr

2021

Quelle

MEDLINE

Beschreibungen/Notizen

• ObjectivesDue to the high interindividual variability in vancomycin pharmacokinetics, optimisation of its dosing is still challenging. This study aimed to explore vancomycin pharmacokinetics in adult patients and to propose an easy applicable dosing nomogram for initial treatment.MethodsVancomycin pharmacokinetics was calculated in a two-compartmental model based on therapeutic drug monitoring data. A linear regression model was used to explore the relationship between vancomycin elimination half-life and glomerular filtration rate estimated according the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula.ResultsIn the whole study population (n=66), vancomycin volume of distribution, clearance and half-life median (IQR) values were 0.69 (0.58–0.87) L/kg, 0.031 (0.022–0.050) L/h/kg and 14.4 (9.5–25.2) hours, respectively. Vancomycin half-life was associated with glomerular filtration rate (r2=0.4126, p<0.0001) according to the formula: t1/2 (h) = −0.247×eGFRCKD-EPI (mL/min/1.73 m2)+32.89. This relationship was used to construct a dosing nomogram.ConclusionsWe propose an easy-to-use dosing nomogram for vancomycin therapy initiation that allows individualisation of the dosing interval with respect to the administered dose size and functional renal status.