A simulation of loading doses for vancomycin continuous infusion regimens in intensive care
Language English Country Great Britain, England Media print-electronic
Document type Journal Article, Observational Study
- Keywords
- Vancomycin, body weight, continuous infusion, obesity, pharmacokinetics, volume of distribution,
- MeSH
- Infusions, Intravenous MeSH
- Middle Aged MeSH
- Humans MeSH
- Obesity MeSH
- Critical Care methods MeSH
- Computer Simulation MeSH
- Half-Life MeSH
- Retrospective Studies MeSH
- Aged MeSH
- Body Weight MeSH
- Vancomycin administration & dosage blood therapeutic use MeSH
- Dose-Response Relationship, Drug MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Observational Study MeSH
- Names of Substances
- Vancomycin MeSH
BACKGROUND: Delayed achievement of target vancomycin serum concentrations may adversely affect clinical outcomes. The objective of this retrospective study was to compare the prediction accuracy of different body weight descriptors for volume of distribution and to propose an optimal loading dose (LD) for continuous infusion regimens in adults. METHODS: Pharmacokinetic variables were computed using one-compartmental analysis. Simulated LDs of vancomycin were evaluated for each patient. RESULTS: Volume of distribution, clearance, and half-life median values (interquartile range) for vancomycin in the study population (n = 30) were 0.45 (0.39-0.61) L.kg-1, 0.026 (0.015-0.040) L.h-1.kg-1, and 10.3 (7.7-21.3) h, respectively. The observed volume of distribution was better predicted by total body weight (TBW) than by the ideal body weight or the adjusted body weight. CONCLUSIONS: An LD of 10.7 mg per kg TBW was optimal in our study population. Using this LD, 17.9% of simulated vancomycin serum levels were just below the therapeutic range, only 10.7% concentrations exceeded the target range and no concentration was toxic. The use of a LD would lead to reduced median time to reach target concentrations from 17 to 1 h.
References provided by Crossref.org
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