Investigation of the prediction accuracy of vancomycin concentrations determined by patient-specific parameters as estimated by Bayesian analysis.
Background/Objective: There have been many studies of therapeutic drug monitoring (TDM) of vancomycin (VCM) based on Bayesian analysis, but there have been no reports of the accuracy of prediction based on Bayesian-estimated patient-specific parameters. This study was conducted to compare the accura...
| Publicado en: | Journal of Clinical Pharmacy & Therapeutics Vol. 35; no. 5; pp. 527 - 533 |
|---|---|
| Autores principales: | , , , |
| Formato: | equations & formulas research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Oct2010
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105099231&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105099231 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02694727 EV4 jtl: Journal of Clinical Pharmacy & Therapeutics issn: 02694727 maglogo: Y pubinfo: dt: Oct2010 vid: 35 iid: 5 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 105099231 53541380 10.1111/j.1365-2710.2009.01126.x 105099231 ppf: 527 ppct: 6 formats: fmt: @attributes: type: P tig: atl: Investigation of the prediction accuracy of vancomycin concentrations determined by patient-specific parameters as estimated by Bayesian analysis. aug: au: Hiraki Y Onga T Mizoguchi A Tsuji Y affil: Department of Pharmacy, National Hospital Organization Nagasaki Medical Center, Kubara, Omura, Nagasaki sug: subj: Vancomycin Pharmacokinetics Drug Monitoring Methods Vancomycin Blood Human Staphylococcal Infections Drug Therapy Vancomycin Therapeutic Use Japan Descriptive Statistics Male Female Adolescence Adult Middle Age Aged Aged, 80 and Over Models, Biological Confidence Intervals Paired T-Tests Data Analysis Software Correlation Coefficient Vancomycin Administration and Dosage Creatinine Blood Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Male Female ab: Background/Objective: There have been many studies of therapeutic drug monitoring (TDM) of vancomycin (VCM) based on Bayesian analysis, but there have been no reports of the accuracy of prediction based on Bayesian-estimated patient-specific parameters. This study was conducted to compare the accuracy of prediction based on the population pharmacokinetic (PPK) method and Bayesian-estimated parameters. Method: The subjects were 22 patients who were treated with VCM for MRSA infection and whose blood was sampled twice or more during the administration period. The concentrations between the blood samples were predicted based on the concentrations in the first blood samples based on the PPK method using mean parameters for the Japanese population and Bayesian-estimated patient-specific pharmacokinetic parameters. The mean prediction error (ME), mean absolute error (MAE) and root mean squared error (RMSE) were compared to examine the accuracy of prediction based on Bayesian-estimated patient-specific parameters. Results and discussion: The mean measured VCM concentration was 10·43 ± 5·19 μg/mL, whereas the mean concentration predicted based on the PPK method was 8·52 ± 4·34 μg/mL, with an ME of −1·91, MAE of 2·93 and RMSE of 3·21. The mean concentration predicted based on patient-specific parameters was 9·62 ± 4·95 μg/mL with ME of −0·81, MAE of 1·38 and RMSE of 1·74. The ME and MAE for the concentrations predicted using patient-specific parameters were smaller compared with those predicted using the PPK method ( P = 0·0471 and 0·0003, respectively), indicating superior prediction with a significant difference between approaches. Conclusion: Prediction using Bayesian estimates of patient-specific parameters was better than by the PPK method. However, when using patient-specific parameters it is still necessary to fully understand the clinical status of the patient and frequently determine VCM concentrations. pubtype: Academic Journal doctype: equations & formulas research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|