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


CONCLUSIONS
The population pharmacokinetic parameters of vancomycin obtained here can be used to individualize the dosage of vancomycin in institutions with similar patient population characteristics.
Yamamoto
M
M
Department of Neuropsychopharmacology and Hospital Pharmacy, Nagoya University Graduate School of Medicine 65, Showa-ku, Nagoya, Japan.
Kuzuya
T
T
Baba
H
H
Yamada
K
K
Nabeshima
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics* / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003404:Creatinine / Q000097:blood / Q000652:urine; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D017711:Nonlinear Dynamics; D018410:Pneumonia, Bacterial / Q000188:drug therapy; D012189:Retrospective Studies; D014018:Tissue Distribution; D014640:Vancomycin / Q000493:pharmacokinetics* / Q000627:therapeutic use; D055815:Young Adult
D000900:Anti-Bacterial Agents; D014640:Vancomycin; D003404:Creatinine