Vancomycin in Pediatric Patients with Cystic Fibrosis: Dose Optimization Using Population Pharmacokinetic Approach

IF 1.9 4区 医学 Q3 PHARMACOLOGY & PHARMACY
Aysenur Yaliniz, Mathieu Blouin, Marie-Élaine Métras, Marie-Christine Boulanger, Karine Cloutier, Marie-Hélène Dubé, Julie Autmizguine, Amélie Marsot
{"title":"Vancomycin in Pediatric Patients with Cystic Fibrosis: Dose Optimization Using Population Pharmacokinetic Approach","authors":"Aysenur Yaliniz, Mathieu Blouin, Marie-Élaine Métras, Marie-Christine Boulanger, Karine Cloutier, Marie-Hélène Dubé, Julie Autmizguine, Amélie Marsot","doi":"10.1007/s13318-024-00913-4","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>An increase in <i>Staphylococcus aureus</i> infections has been reported in pediatric patients with cystic fibrosis (CF) over the last few years. This pathogen is commonly treated with vancomycin, an antibiotic for which therapeutic drug monitoring (TDM) is recommended. Updated guidelines were recently published regarding new targets of exposure for the TDM of vancomycin through a Bayesian approach, using population pharmacokinetic (popPK) models.</p><h3 data-test=\"abstract-sub-heading\">Objectives</h3><p>This study aims to assess the predictive performance of vancomycin popPK models in pediatric patients with CF and to recommend optimal initial dosing regimens based on simulations.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Patient data were collected from two centers in Canada, and a literature review was conducted to identify all published vancomycin popPK models for pediatric CF patients. External evaluation and simulations were performed according to patient and occasion of treatment.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>A total of 53 vancomycin concentrations were collected from six pediatric CF patients. Only two popPK models of vancomycin for pediatric CF patients were identified through the literature review. The external evaluation results for both centers combined revealed a population bias of 28.1% and an imprecision of 33.7%. A re-estimation of parameters was performed to improve predictive performance. The optimal initial dosing regimen was 15 mg/kg/dose administered every 6 hours according to the per occasion remodel.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>The predictive performance and identified optimal initial dosing regimens associated with the model were different depending on the data used, showing external evaluation’s importance before implementing a model in clinical practice.</p>","PeriodicalId":11939,"journal":{"name":"European Journal of Drug Metabolism and Pharmacokinetics","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Drug Metabolism and Pharmacokinetics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s13318-024-00913-4","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
引用次数: 0

Abstract

Background

An increase in Staphylococcus aureus infections has been reported in pediatric patients with cystic fibrosis (CF) over the last few years. This pathogen is commonly treated with vancomycin, an antibiotic for which therapeutic drug monitoring (TDM) is recommended. Updated guidelines were recently published regarding new targets of exposure for the TDM of vancomycin through a Bayesian approach, using population pharmacokinetic (popPK) models.

Objectives

This study aims to assess the predictive performance of vancomycin popPK models in pediatric patients with CF and to recommend optimal initial dosing regimens based on simulations.

Methods

Patient data were collected from two centers in Canada, and a literature review was conducted to identify all published vancomycin popPK models for pediatric CF patients. External evaluation and simulations were performed according to patient and occasion of treatment.

Results

A total of 53 vancomycin concentrations were collected from six pediatric CF patients. Only two popPK models of vancomycin for pediatric CF patients were identified through the literature review. The external evaluation results for both centers combined revealed a population bias of 28.1% and an imprecision of 33.7%. A re-estimation of parameters was performed to improve predictive performance. The optimal initial dosing regimen was 15 mg/kg/dose administered every 6 hours according to the per occasion remodel.

Conclusion

The predictive performance and identified optimal initial dosing regimens associated with the model were different depending on the data used, showing external evaluation’s importance before implementing a model in clinical practice.

Abstract Image

万古霉素在小儿囊性纤维化患者中的应用:使用群体药代动力学方法优化剂量
背景据报道,在过去几年中,囊性纤维化(CF)儿童患者中的金黄色葡萄球菌感染有所增加。这种病原体通常使用万古霉素治疗,建议对这种抗生素进行治疗药物监测(TDM)。本研究旨在评估万古霉素流行药代动力学模型在儿科 CF 患者中的预测性能,并根据模拟结果推荐最佳初始给药方案。方法从加拿大的两个中心收集患者数据,并进行文献综述,以确定所有已发表的适用于儿科 CF 患者的万古霉素流行药代动力学模型。结果从 6 名儿科 CF 患者身上共收集到 53 个万古霉素浓度。通过文献综述,仅发现了两个针对儿科 CF 患者的万古霉素 popPK 模型。两个中心的外部评估结果显示,人群偏倚率为 28.1%,不精确率为 33.7%。为提高预测性能,对参数进行了重新估计。结论模型的预测性能和确定的最佳初始给药方案因使用的数据而异,这表明在临床实践中实施模型之前,外部评估非常重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
3.70
自引率
0.00%
发文量
64
审稿时长
>12 weeks
期刊介绍: Hepatology International is a peer-reviewed journal featuring articles written by clinicians, clinical researchers and basic scientists is dedicated to research and patient care issues in hepatology. This journal focuses mainly on new and emerging diagnostic and treatment options, protocols and molecular and cellular basis of disease pathogenesis, new technologies, in liver and biliary sciences. Hepatology International publishes original research articles related to clinical care and basic research; review articles; consensus guidelines for diagnosis and treatment; invited editorials, and controversies in contemporary issues. The journal does not publish case reports.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信