title: Peak Measurement for Vancomycin AUC Estimation in Obese Adults Improves Precision and Lowers Bias.
abstract: Vancomycin area under the curve (AUC) estimates may be skewed in obese adults due to weight-dependent pharmacokinetic parameters. We demonstrate that peak and trough measurements reduce bias and improve the precision of vancomycin AUC estimates in obese adults (n= 75) and validate this in an independent cohort (n= 31). The precision and mean percent bias of Bayesian vancomycin AUC estimates are comparable between covariate-dependent (R2= 0.774, 3.55%) and covariate-independent (R2= 0.804, 3.28%) models when peaks and troughs are measured but not when measurements are restricted to troughs only (R2= 0.557, 15.5%).
authors.affiliation: Department of Clinical Pharmacy, College of Pharmacy, University of Michigan, Ann Arbor, Michigan, USA amitpai@umich.edu.
authors.forename: Manjunath P
authors.initials: MP
authors.lastname: Pai
authors.affiliation: Morton Plant Hospital, BayCare Health System, Clearwater, Florida, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Hong
authors.affiliation: Morton Plant Hospital, BayCare Health System, Clearwater, Florida, USA.
authors.forename: Lynne
authors.initials: L
authors.lastname: Krop
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics*; D019540:Area Under Curve; D001499:Bayes Theorem; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009765:Obesity / Q000378:metabolism*; D014640:Vancomycin / Q000493:pharmacokinetics*
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin
keywords: MRSA; obese; obesity; peak; pharmacodynamics; pharmacokinetics; population pharmacokinetics; trough; vancomycin