title: A Population Pharmacokinetic Model for Vancomycin in Adult Patients Receiving Extracorporeal Membrane Oxygenation Therapy.
abstract: The literature on the pharmacokinetics of vancomycin in patients undergoing extracorporeal membrane oxygenation (ECMO) therapy is sparse. A population pharmacokinetic (PK) model for vancomycin in ECMO patients was developed using a nonlinear mixed effects modeling on the concentration-time profiles of 14 ECMO patients who received intravenous vancomycin. Model selection was based on log-likelihood criterion, goodness of fit plots, and scientific plausibility. Identification of covariates was done using a full covariate model approach. The pharmacokinetics of vancomycin was adequately described with a two-compartment model. Parameters included clearance of 2.83 L/hr, limited central volume of distribution 24.2 L, and low residual variability 0.67%. Findings from the analysis suggest that standard dosing recommendations for vancomycin in non-ECMO patients are adequate to achieve therapeutic trough concentrations in ECMO patients. This further shows that ECMO minimally affects the PK of vancomycin in adults including in higher-weight patients.
authors.affiliation: Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, Pennsylvania, USA. JasonMooreRx@gmail.com.
authors.forename: J N
authors.initials: JN
authors.lastname: Moore
authors.affiliation: Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
authors.forename: J R
authors.initials: JR
authors.lastname: Healy
authors.affiliation: Department of Pharmacy, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, USA.
authors.forename: B N
authors.initials: BN
authors.lastname: Thoma
authors.affiliation: Department of Pharmacy, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, USA.
authors.forename: M M
authors.initials: MM
authors.lastname: Peahota
authors.affiliation: Quantitative Pharmacology and Pharmacometrics, Pharmacokinetics, Pharmacodynamics & Drug Metabolism, Merck Research Laboratories, Merck & Co., Inc., Upper Gwynedd, Pennsylvania, USA.
authors.forename: M
authors.initials: M
authors.lastname: Ahamadi
authors.affiliation: Department of Pharmacy, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, USA.
authors.forename: L
authors.initials: L
authors.lastname: Schmidt
authors.affiliation: Department of Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
authors.forename: N C
authors.initials: NC
authors.lastname: Cavarocchi
authors.affiliation: Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
authors.forename: W K
authors.initials: WK
authors.lastname: Kraft
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000097:blood* / Q000493:pharmacokinetics; D015199:Extracorporeal Membrane Oxygenation / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D009010:Monte Carlo Method; D017711:Nonlinear Dynamics; D011446:Prospective Studies; D014640:Vancomycin / Q000097:blood* / Q000493:pharmacokinetics
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin