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Predicting the Area under the Plasma Concentration-Time Curve (AUC) for First Dose Vancomycin Using First-Order Pharmacokinetic Equations

To treat critically ill patients, early achievement of the target area under the plasma concentration-time curve/minimum inhibitory concentration (AUC/MIC) in the first 24 h is recommended. However, accurately calculating the AUC before steady state is an obstacle to this goal. A first-order pharmac...

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Autores principales: Sujjavorakul, Kritsaporn, Katip, Wasan, Kerr, Stephen J., Wacharachaisurapol, Noppadol, Puthanakit, Thanyawee
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10135334/
https://www.ncbi.nlm.nih.gov/pubmed/37106993
http://dx.doi.org/10.3390/antibiotics12040630
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author Sujjavorakul, Kritsaporn
Katip, Wasan
Kerr, Stephen J.
Wacharachaisurapol, Noppadol
Puthanakit, Thanyawee
author_facet Sujjavorakul, Kritsaporn
Katip, Wasan
Kerr, Stephen J.
Wacharachaisurapol, Noppadol
Puthanakit, Thanyawee
author_sort Sujjavorakul, Kritsaporn
collection PubMed
description To treat critically ill patients, early achievement of the target area under the plasma concentration-time curve/minimum inhibitory concentration (AUC/MIC) in the first 24 h is recommended. However, accurately calculating the AUC before steady state is an obstacle to this goal. A first-order pharmacokinetic equation to calculate vancomycin AUC after a first dose of vancomycin has never been studied. We sought to estimate AUC using two first-order pharmacokinetic equations, with different paired concentration time points, and to compare these to the actual first dose vancomycin AUC calculated by the linear-log trapezoid rule as a reference. The equations were validated using two independent intensive first dose vancomycin concentration time data sets, one from 10 adults and another from 14 children with severe infection. The equation with compensation for the alpha distribution phase using a first vancomycin serum concentration from 60 to 90 min and the second concentration from 240 to 300 min after the completed infusion showed good agreement and low bias of calculated AUC, with mean differences <5% and Lin’s correlation coefficient >0.96. Moreover, it gave an excellent correlation with Pearson’s r > 0.96. Estimating the first dose vancomycin AUC calculated using this first-order pharmacokinetic equation is both reliable and reproducible in clinical practice settings.
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spelling pubmed-101353342023-04-28 Predicting the Area under the Plasma Concentration-Time Curve (AUC) for First Dose Vancomycin Using First-Order Pharmacokinetic Equations Sujjavorakul, Kritsaporn Katip, Wasan Kerr, Stephen J. Wacharachaisurapol, Noppadol Puthanakit, Thanyawee Antibiotics (Basel) Article To treat critically ill patients, early achievement of the target area under the plasma concentration-time curve/minimum inhibitory concentration (AUC/MIC) in the first 24 h is recommended. However, accurately calculating the AUC before steady state is an obstacle to this goal. A first-order pharmacokinetic equation to calculate vancomycin AUC after a first dose of vancomycin has never been studied. We sought to estimate AUC using two first-order pharmacokinetic equations, with different paired concentration time points, and to compare these to the actual first dose vancomycin AUC calculated by the linear-log trapezoid rule as a reference. The equations were validated using two independent intensive first dose vancomycin concentration time data sets, one from 10 adults and another from 14 children with severe infection. The equation with compensation for the alpha distribution phase using a first vancomycin serum concentration from 60 to 90 min and the second concentration from 240 to 300 min after the completed infusion showed good agreement and low bias of calculated AUC, with mean differences <5% and Lin’s correlation coefficient >0.96. Moreover, it gave an excellent correlation with Pearson’s r > 0.96. Estimating the first dose vancomycin AUC calculated using this first-order pharmacokinetic equation is both reliable and reproducible in clinical practice settings. MDPI 2023-03-23 /pmc/articles/PMC10135334/ /pubmed/37106993 http://dx.doi.org/10.3390/antibiotics12040630 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Sujjavorakul, Kritsaporn
Katip, Wasan
Kerr, Stephen J.
Wacharachaisurapol, Noppadol
Puthanakit, Thanyawee
Predicting the Area under the Plasma Concentration-Time Curve (AUC) for First Dose Vancomycin Using First-Order Pharmacokinetic Equations
title Predicting the Area under the Plasma Concentration-Time Curve (AUC) for First Dose Vancomycin Using First-Order Pharmacokinetic Equations
title_full Predicting the Area under the Plasma Concentration-Time Curve (AUC) for First Dose Vancomycin Using First-Order Pharmacokinetic Equations
title_fullStr Predicting the Area under the Plasma Concentration-Time Curve (AUC) for First Dose Vancomycin Using First-Order Pharmacokinetic Equations
title_full_unstemmed Predicting the Area under the Plasma Concentration-Time Curve (AUC) for First Dose Vancomycin Using First-Order Pharmacokinetic Equations
title_short Predicting the Area under the Plasma Concentration-Time Curve (AUC) for First Dose Vancomycin Using First-Order Pharmacokinetic Equations
title_sort predicting the area under the plasma concentration-time curve (auc) for first dose vancomycin using first-order pharmacokinetic equations
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10135334/
https://www.ncbi.nlm.nih.gov/pubmed/37106993
http://dx.doi.org/10.3390/antibiotics12040630
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