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Assessing the accuracy of two Bayesian forecasting programs in estimating vancomycin drug exposure

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dc.contributor.authorShingde, R.V.
dc.contributor.authorReuter, S.E.
dc.contributor.authorGraham, G.G.
dc.contributor.authorCarland, J.E.
dc.contributor.authorWilliams, K.M.
dc.contributor.authorDay, R.O.
dc.contributor.authorStocker, S.L.
dc.date.issued2020
dc.descriptionData source: Supplementary date, https://doi.org/10.1093/jac/dkaa320
dc.description.abstractBackground: Current guidelines for intravenous vancomycin identify drug exposure (as indicated by the AUC) as the best pharmacokinetic (PK) indicator of therapeutic outcome. Objectives: To assess the accuracy of two Bayesian forecasting programs in estimating vancomycin AUC0–1 in adults with limited blood concentration sampling. Methods: The application of seven vancomycin population PK models in two Bayesian forecasting programs was examined in non-obese adults (n = 22) with stable renal function. Patients were intensively sampled following a single (1000 mg or 15 mg/kg) dose. For each patient, AUC was calculated by fitting all vancomycin concentrations to a two-compartment model (defined as AUCTRUE). AUCTRUE was then compared with the Bayesian-estimated AUC0–1 values using a single vancomycin concentration sampled at various times post-infusion. Results: Optimal sampling times varied across different models. AUCTRUE was generally overestimated at earlier sampling times and underestimated at sampling times after 4 h post-infusion. The models by Goti et al. (Ther Drug Monit 2018; 40: 212–21) and Thomson et al. (J Antimicrob Chemother 2009; 63: 1050–7) had precise and unbiased sampling times (defined as mean imprecision <25% and <38 mgh/L, with 95% CI for mean bias containing zero) between 1.5 and 6 h and between 0.75 and 2 h post-infusion, respectively. Precise but biased sampling times for Thomson et al. were between 4 and 6 h post-infusion. Conclusions: When using a single vancomycin concentration for Bayesian estimation of vancomycin drug exposure (AUC), the predictive performance was generally most accurate with sample collection between 1.5 and 6 h after infusion, though optimal sampling times varied across different population PK models.
dc.identifier.citationJournal of Antimicrobial Chemotherapy, 2020; 75(11):3239-3302
dc.identifier.doi10.1093/jac/dkaa320
dc.identifier.issn0305-7453
dc.identifier.issn1460-2091
dc.identifier.urihttps://hdl.handle.net/11541.2/146015
dc.language.isoen
dc.publisherOxford University Press
dc.rightsCopyright 2020 The author(s). Published by Oxford University Press
dc.source.urihttps://doi.org/10.1093/jac/dkaa320
dc.subjectintravenous vancomycin
dc.subjectBayesian estimation
dc.subjectpost-infusion
dc.titleAssessing the accuracy of two Bayesian forecasting programs in estimating vancomycin drug exposure
dc.typeJournal article
pubs.publication-statusPublished
ror.mmsid9916458211501831

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