Are All Pharmacokinetic Equations Created Equal? A Comparative Analysis of Trapezoidal and Non-Trapezoidal Methods for Estimating Day 1 Area Under the Curve in Adult Hospitalized Patients with Staphylococcus aureus Bacteremia.

IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES
Infectious Diseases and Therapy Pub Date : 2025-03-01 Epub Date: 2025-02-17 DOI:10.1007/s40121-025-01115-4
Abdulwhab Shremo Msdi, Alireza Fakhri Ravari, Jacinda C Abdul-Mutakabbir, Karen K Tan
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引用次数: 0

Abstract

Introduction: This study compared the calculated vancomycin area under the curve (AUC0-24) using trapezoidal and non-trapezoidal first-order pharmacokinetic equations.

Methods: This retrospective observational study included adult patients with documented MRSA bacteremia who received ≥ 48 h of intravenous vancomycin and had two consecutive serum levels after the first dose. AUC0-24 was calculated using trapezoidal and non-trapezoidal equations. Correlation and agreement between methods were assessed using Pearson's correlation coefficient (r) and Bland-Altman plots. Significant predictors (p < 0.05) from simple linear regression were included in a multiple linear regression model to evaluate their impact on AUC0-24 for both methods.

Results: Fifty-two patients were included. The median age was 63 years (interquartile range [IQR]: 50-73), and the median vancomycin clearance was 4 l/h (IQR: 2-6). Median vancomycin AUC0-24 was 399 mg∙h/l (IQR: 257-674) for the trapezoidal method and 572 mg∙h/l (IQR: 466-807) for the non-trapezoidal method. There was a strong correlation between the methods (r = 0.87 [95% CI, 0.79-1]; P < 0.01), but Bland-Altman analysis showed poor agreement, with a bias of - 198 mg∙h/l and 95% limits of agreement from - 482 to 86 mg∙h/l. In multiple linear regression, total daily dose and vancomycin clearance were independent predictors of AUC0-24 for both methods, with a stronger impact on non-trapezoidal AUC0-24 (adjusted R2 = 0.70) than trapezoidal AUC0-24 (adjusted R2 = 0.59).

Conclusions: Trapezoidal and non-trapezoidal equations are not interchangeable for estimating vancomycin AUC0-24. The trapezoidal method consistently results in lower AUC0-24 estimates than the non-trapezoidal method.

所有的药代动力学方程都是相等的吗?金黄色葡萄球菌菌血症成人住院患者第1天曲线下面积估算的梯形法与非梯形法的比较分析
本研究采用梯形和非梯形一级药代动力学方程,比较计算得到的万古霉素曲线下面积(AUC0-24)。方法:本回顾性观察性研究纳入有MRSA菌血症记录的成人患者,这些患者静脉注射万古霉素≥48小时,首次给药后连续两次血清水平。AUC0-24采用梯形和非梯形方程计算。使用Pearson相关系数(r)和Bland-Altman图评估方法之间的相关性和一致性。两种方法的显著预测因子(p 0-24)。结果:纳入52例患者。年龄中位数为63岁(四分位数间距[IQR]: 50-73),万古霉素清除率中位数为4 l/h (IQR: 2-6)。梯形法万古霉素AUC0-24的中位数为399 mg∙h/l (IQR: 257-674),非梯形法为572 mg∙h/l (IQR: 466-807)。两种方法之间有很强的相关性(r = 0.87 [95% CI, 0.79-1];两种方法对非梯形AUC0-24的影响(校正R2 = 0.70)大于梯形AUC0-24(校正R2 = 0.59)。结论:梯形方程和非梯形方程在估计万古霉素AUC0-24时不可互换。梯形法得到的AUC0-24估计值始终低于非梯形法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Infectious Diseases and Therapy
Infectious Diseases and Therapy Medicine-Microbiology (medical)
CiteScore
8.60
自引率
1.90%
发文量
136
审稿时长
6 weeks
期刊介绍: Infectious Diseases and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of infectious disease therapies and interventions, including vaccines and devices. Studies relating to diagnostic products and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, bacterial and fungal infections, viral infections (including HIV/AIDS and hepatitis), parasitological diseases, tuberculosis and other mycobacterial diseases, vaccinations and other interventions, and drug-resistance, chronic infections, epidemiology and tropical, emergent, pediatric, dermal and sexually-transmitted diseases.
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