Do vancomycin pharmacokinetics differ between obese and non-obese patients? Comparison of a general-purpose and four obesity-specific pharmacokinetic models
Colin, Pieter J. and Eleveld, Douglas J. and Hart, Andrew and Thomson, Alison H. (2021) Do vancomycin pharmacokinetics differ between obese and non-obese patients? Comparison of a general-purpose and four obesity-specific pharmacokinetic models. Therapeutic Drug Monitoring, 43 (1). pp. 126-130. ISSN 0163-4356 (https://doi.org/10.1097/FTD.0000000000000832)
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Abstract
Background: Over the past decade, numerous obesity-specific pharmacokinetic (PK) models and dosage regimens have been developed. However, it is unclear whether vancomycin PKs differ between obese and other patients after accounting for weight, age, and kidney function. In this study, the authors investigated whether using obesity-specific population PK models for vancomycin offers any advantage in accuracy and precision over using a recently developed general-purpose model. Methods: Vancomycin plasma concentrations in a cohort of 49 obese patients (body mass index [BMI] >30 kg/m2), not previously used in the development of any of the evaluated models, were used to validate the performance of 4 obesity-specific models and a general model. Bias and imprecision were calculated for the a priori and a posteriori predictive performance. Results: The bias of the a priori prediction was lowest for one of the obesity-specific models (−1.40%) and that of the general model was a close second (−7.0%). The imprecision was lowest for the general model (4.34 mg/L). The predictive performance for the a posteriori predictions was best for the general model, both for bias (1.96%) and imprecision (2.75 mg/L). Conclusions: The results of the external validation of vancomycin PK in obese patients showed that currently available obesity-specific models do not necessarily outperform a broadly supported general-purpose model. Based on these results, the authors conclude that there is no advantage in using vancomycin PK models specifically tailored to obese patients over the general-purpose model reported by Colin et al.
ORCID iDs
Colin, Pieter J., Eleveld, Douglas J., Hart, Andrew and Thomson, Alison H. ORCID: https://orcid.org/0000-0002-2354-6116;-
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Item type: Article ID code: 75321 Dates: DateEvent28 February 2021Published15 October 2020Accepted10 June 2020SubmittedSubjects: Medicine > Pharmacy and materia medica Department: Faculty of Science > Strathclyde Institute of Pharmacy and Biomedical Sciences Depositing user: Pure Administrator Date deposited: 04 Feb 2021 15:53 Last modified: 12 Dec 2024 08:43 URI: https://strathprints.strath.ac.uk/id/eprint/75321