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Evaluation of Vancomycin Area Under the Concentration–Time Curve Predictive Performance Using Bayesian Modeling Software With and Without Peak Concentration: An Academic Hospital Experience for Adult Patients Without Renal Impairment
- Title
- Evaluation of Vancomycin Area Under the Concentration–Time Curve Predictive Performance Using Bayesian Modeling Software With and Without Peak Concentration: An Academic Hospital Experience for Adult Patients Without Renal Impairment
- Authors
- Kim; Hyun-Ki; Jeong; Tae-Dong
- Ewha Authors
- 정태동
- SCOPUS Author ID
- 정태동
- Issue Date
- 2023
- Journal Title
- Annals of Laboratory Medicine
- ISSN
- 2234-3806
- Citation
- Annals of Laboratory Medicine vol. 43, no. 6, pp. 554 - 564
- Keywords
- Area under the curve; Peak; Therapeutic drug monitoring; Trough; Vancomycin
- Publisher
- Seoul National University, Institute for Cognitive Science
- Indexed
- SCIE; SCOPUS; KCI
- Document Type
- Article
- Abstract
- Background: The revised U.S. consensus guidelines on vancomycin therapeutic drug monitoring (TDM) recommend obtaining trough and peak samples to estimate the area under the concentration–time curve (AUC) using the Bayesian approach; however, the benefit of such two-point measurements has not been demonstrated in a clinical setting. We evaluated Bayesian predictive performance with and without peak concentration data using clinical TDM data. Methods: We retrospectively analyzed 54 adult patients without renal impairment who had two serial peak and trough concentration measurements in a ≤1-week interval. The concentration and AUC values were estimated and predicted using Bayesian software (MwPharm++; Mediware, Prague, Czech Republic). The median prediction error (MDPE) for bias and median absolute prediction error (MDAPE) for imprecision were calculated based on the estimated AUC and measured trough concentration. Results: AUC predictions using the trough concentration had an MDPE of –1.6% and an MDAPE of 12.4%, whereas those using both peak and trough concentrations had an MDPE of –6.2% and an MDAPE of 16.9%. Trough concentration predictions using the trough concentration had an MDPE of –8.7% and an MDAPE of 18.0%, whereas those using peak and trough concentrations had an MDPE of –13.2% and an MDAPE of 21.0%. Conclusions: The usefulness of the peak concentration for predicting the AUC on the next occasion by Bayesian modeling was not demonstrated; therefore, the practical value of peak sampling for AUC-guided dosing can be questioned. As this study was conducted in a specific setting and generalization is limited, results should be interpreted cautiously. © Korean Society for Laboratory Medicine.
- DOI
- 10.3343/alm.2023.43.6.554
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
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