Population pharmacokinetic analysis of vancomycin in patients with gram-positive infections and the influence of infectious disease type

J Clin Pharm Ther. 2009 Aug;34(4):473-83. doi: 10.1111/j.1365-2710.2008.01016.x.

Abstract

Objective: To describe the population pharmacokinetics of vancomycin in patients with gram-positive infections and to investigate the influence of type of infectious disease.

Methods: A two-compartment open model was adopted as a pharmacokinetic model. The nonlinear mixed-effects model was used to analyze the population pharmacokinetic models.

Results: We propose one general model and one infectious disease type-specific model. The general model showed that vancomycin clearance (CL) was linearly correlated with estimated creatinine clearance (CL(CR)) when CL(CR) was less than 85 mL/min, as expressed by CL(L/h) = 0.0322 x CL(CR) + 0.32. The distribution volumes of the central and peripheral compartment were different in healthy volunteers and patients with gram-positive infections. The infectious disease type-specific model showed that these differences were more pronounced in patients with pneumonia.

Conclusion: The population pharmacokinetic parameters of vancomycin obtained here can be used to individualize the dosage of vancomycin in institutions with similar patient population characteristics.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / pharmacokinetics*
  • Anti-Bacterial Agents / therapeutic use
  • Clinical Trials as Topic
  • Creatinine / blood
  • Creatinine / urine
  • Female
  • Gram-Positive Bacterial Infections / drug therapy*
  • Humans
  • Male
  • Middle Aged
  • Models, Biological*
  • Nonlinear Dynamics
  • Pneumonia, Bacterial / drug therapy
  • Retrospective Studies
  • Tissue Distribution
  • Vancomycin / pharmacokinetics*
  • Vancomycin / therapeutic use
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Vancomycin
  • Creatinine