In:
The Journal of Clinical Pharmacology, Wiley, Vol. 59, No. 12 ( 2019-12), p. 1597-1605
Kurzfassung:
The 24‐hour vancomycin area under the serum concentration‐time curve (AUC 24 ) divided by the minimum inhibitory concentration (MIC) (AUC 24 /MIC) is more closely related to patient outcomes than serum trough concentrations (C trough ). Two‐point simplified equations for calculating AUC based on serum peak concentrations (C peak ) and C trough , named equation A (EqA) and equation B (EqB), have recently been adopted into clinical use for adult pediatric patients. We aimed to find the agreement between predicted AUC 24 using the reference method (ref) relative to EqA and EqB and the correlation between C trough and AUC 24 . From June to December 2018, 43 pediatric patients with normal renal function, receiving 15 mg/kg of vancomycin intravenously every 6 hours, were enrolled. The pediatric patients’ median age was 2.2 years (range 0.1‐15.3). At steady state, vancomycin C peak and C trough were measured at 2 hours after infusion completion and within 30 minutes before the next dosing, respectively. AUC 24 was estimated using ref, EqA, and EqB. From Bland‐Altman analysis, the 2 AUC 24 s estimated by ref and EqA showed less bias than those estimated by ref and EqB (bias 1.3 and –72.1 mg⋅h/L, respectively). C trough and AUC 24 using either ref or EqA were correlated more closely ( r 2 = 0.94) than with EqB ( r 2 = 0.86). Assuming a vancomycin MIC of 1 mg/L, an AUC 24 ≥400 mg⋅h/L was targeted. Regardless of the method used, AUC 24 ≥400 mg⋅h/L was never seen with C trough 〈 8 mg/L but was always seen with C trough 〉 10 mg/L. In conclusion, EqA based on the 2 measured serum concentrations was sufficiently accurate for AUC 24 estimation. C trough 〉 10 mg/L correlated highly to AUC 24 ≥400 mg⋅h/L.
Materialart:
Online-Ressource
ISSN:
0091-2700
,
1552-4604
Sprache:
Englisch
Verlag:
Wiley
Publikationsdatum:
2019
ZDB Id:
2010253-7
SSG:
15,3
