Dose Tailoring of Vancomycin Through Population Pharmacokinetic Modeling Among Surgical Patients in Pakistan

Background: Vancomycin is a narrow therapeutic agent, and it is necessary to optimize the dose to achieve safe therapeutic outcomes. The purpose of this study was to identify the significant covariates for vancomycin clearance and to optimize the dose among surgical patients in Pakistan.Methods: Pla...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Muhammad Muaaz Munir, Huma Rasheed, Muhammad Imran Khokhar, Rizwan Rasul Khan, Hafiz Asad Saeed, Mateen Abbas, Mohsin Ali, Rabiea Bilal, Hafiz Awais Nawaz, Abdul Muqeet Khan, Shaista Qamar, Syed Muneeb Anjum, Muhammad Usman
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	vancomycin population pharmacokinetics Pakistan NONMEM dose tailoring Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/1658c40d6d364ed0938d23558238cad3
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:1658c40d6d364ed0938d23558238cad3
record_format	dspace
spelling	oai:doaj.org-article:1658c40d6d364ed0938d23558238cad32021-11-11T06:54:15ZDose Tailoring of Vancomycin Through Population Pharmacokinetic Modeling Among Surgical Patients in Pakistan1663-981210.3389/fphar.2021.721819https://doaj.org/article/1658c40d6d364ed0938d23558238cad32021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fphar.2021.721819/fullhttps://doaj.org/toc/1663-9812Background: Vancomycin is a narrow therapeutic agent, and it is necessary to optimize the dose to achieve safe therapeutic outcomes. The purpose of this study was to identify the significant covariates for vancomycin clearance and to optimize the dose among surgical patients in Pakistan.Methods: Plasma concentration data of 176 samples collected from 58 surgical patients treated with vancomycin were used in this study. A population pharmacokinetic model was developed on NONMEM® using plasma concentration–time data. The effect of all available covariates was evaluated on the pharmacokinetic parameters of vancomycin by stepwise covariate modeling. The final model was evaluated using bootstrap, goodness-of-fit plots, and visual predictive checks.Results: The pharmacokinetics of vancomycin followed a one-compartment model with first-order elimination. The vancomycin clearance (CL) and volume of distribution (Vd) were 2.45 L/h and 22.6 l, respectively. Vancomycin CL was influenced by creatinine clearance (CRCL) and body weight of the patients; however, no covariate was significant for its effect on the volume of distribution. Dose tailoring was performed by simulating dosage regimens at a steady state based on the CRCL of the patients. The tailored doses were 400, 600, 800, and 1,000 mg for patients with a CRCL of 20, 60, 100, and 140 ml/min, respectively.Conclusion: Vancomycin CL is influenced by CRCL and body weight of the patient. This model can be helpful for the dose tailoring of vancomycin based on renal status in Pakistani patients.Muhammad Muaaz MunirHuma RasheedMuhammad Imran KhokharRizwan Rasul KhanHafiz Asad SaeedMateen AbbasMohsin AliRabiea BilalHafiz Awais NawazAbdul Muqeet KhanShaista QamarSyed Muneeb AnjumMuhammad UsmanFrontiers Media S.A.articlevancomycinpopulation pharmacokineticsPakistanNONMEMdose tailoringTherapeutics. PharmacologyRM1-950ENFrontiers in Pharmacology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	vancomycin population pharmacokinetics Pakistan NONMEM dose tailoring Therapeutics. Pharmacology RM1-950
spellingShingle	vancomycin population pharmacokinetics Pakistan NONMEM dose tailoring Therapeutics. Pharmacology RM1-950 Muhammad Muaaz Munir Huma Rasheed Muhammad Imran Khokhar Rizwan Rasul Khan Hafiz Asad Saeed Mateen Abbas Mohsin Ali Rabiea Bilal Hafiz Awais Nawaz Abdul Muqeet Khan Shaista Qamar Syed Muneeb Anjum Muhammad Usman Dose Tailoring of Vancomycin Through Population Pharmacokinetic Modeling Among Surgical Patients in Pakistan
description	Background: Vancomycin is a narrow therapeutic agent, and it is necessary to optimize the dose to achieve safe therapeutic outcomes. The purpose of this study was to identify the significant covariates for vancomycin clearance and to optimize the dose among surgical patients in Pakistan.Methods: Plasma concentration data of 176 samples collected from 58 surgical patients treated with vancomycin were used in this study. A population pharmacokinetic model was developed on NONMEM® using plasma concentration–time data. The effect of all available covariates was evaluated on the pharmacokinetic parameters of vancomycin by stepwise covariate modeling. The final model was evaluated using bootstrap, goodness-of-fit plots, and visual predictive checks.Results: The pharmacokinetics of vancomycin followed a one-compartment model with first-order elimination. The vancomycin clearance (CL) and volume of distribution (Vd) were 2.45 L/h and 22.6 l, respectively. Vancomycin CL was influenced by creatinine clearance (CRCL) and body weight of the patients; however, no covariate was significant for its effect on the volume of distribution. Dose tailoring was performed by simulating dosage regimens at a steady state based on the CRCL of the patients. The tailored doses were 400, 600, 800, and 1,000 mg for patients with a CRCL of 20, 60, 100, and 140 ml/min, respectively.Conclusion: Vancomycin CL is influenced by CRCL and body weight of the patient. This model can be helpful for the dose tailoring of vancomycin based on renal status in Pakistani patients.
format	article
author	Muhammad Muaaz Munir Huma Rasheed Muhammad Imran Khokhar Rizwan Rasul Khan Hafiz Asad Saeed Mateen Abbas Mohsin Ali Rabiea Bilal Hafiz Awais Nawaz Abdul Muqeet Khan Shaista Qamar Syed Muneeb Anjum Muhammad Usman
author_facet	Muhammad Muaaz Munir Huma Rasheed Muhammad Imran Khokhar Rizwan Rasul Khan Hafiz Asad Saeed Mateen Abbas Mohsin Ali Rabiea Bilal Hafiz Awais Nawaz Abdul Muqeet Khan Shaista Qamar Syed Muneeb Anjum Muhammad Usman
author_sort	Muhammad Muaaz Munir
title	Dose Tailoring of Vancomycin Through Population Pharmacokinetic Modeling Among Surgical Patients in Pakistan
title_short	Dose Tailoring of Vancomycin Through Population Pharmacokinetic Modeling Among Surgical Patients in Pakistan
title_full	Dose Tailoring of Vancomycin Through Population Pharmacokinetic Modeling Among Surgical Patients in Pakistan
title_fullStr	Dose Tailoring of Vancomycin Through Population Pharmacokinetic Modeling Among Surgical Patients in Pakistan
title_full_unstemmed	Dose Tailoring of Vancomycin Through Population Pharmacokinetic Modeling Among Surgical Patients in Pakistan
title_sort	dose tailoring of vancomycin through population pharmacokinetic modeling among surgical patients in pakistan
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/1658c40d6d364ed0938d23558238cad3
work_keys_str_mv	AT muhammadmuaazmunir dosetailoringofvancomycinthroughpopulationpharmacokineticmodelingamongsurgicalpatientsinpakistan AT humarasheed dosetailoringofvancomycinthroughpopulationpharmacokineticmodelingamongsurgicalpatientsinpakistan AT muhammadimrankhokhar dosetailoringofvancomycinthroughpopulationpharmacokineticmodelingamongsurgicalpatientsinpakistan AT rizwanrasulkhan dosetailoringofvancomycinthroughpopulationpharmacokineticmodelingamongsurgicalpatientsinpakistan AT hafizasadsaeed dosetailoringofvancomycinthroughpopulationpharmacokineticmodelingamongsurgicalpatientsinpakistan AT mateenabbas dosetailoringofvancomycinthroughpopulationpharmacokineticmodelingamongsurgicalpatientsinpakistan AT mohsinali dosetailoringofvancomycinthroughpopulationpharmacokineticmodelingamongsurgicalpatientsinpakistan AT rabieabilal dosetailoringofvancomycinthroughpopulationpharmacokineticmodelingamongsurgicalpatientsinpakistan AT hafizawaisnawaz dosetailoringofvancomycinthroughpopulationpharmacokineticmodelingamongsurgicalpatientsinpakistan AT abdulmuqeetkhan dosetailoringofvancomycinthroughpopulationpharmacokineticmodelingamongsurgicalpatientsinpakistan AT shaistaqamar dosetailoringofvancomycinthroughpopulationpharmacokineticmodelingamongsurgicalpatientsinpakistan AT syedmuneebanjum dosetailoringofvancomycinthroughpopulationpharmacokineticmodelingamongsurgicalpatientsinpakistan AT muhammadusman dosetailoringofvancomycinthroughpopulationpharmacokineticmodelingamongsurgicalpatientsinpakistan
_version_	1718439376793370624

Dose Tailoring of Vancomycin Through Population Pharmacokinetic Modeling Among Surgical Patients in Pakistan

Ejemplares similares