Factors Affecting Vancomycin Trough Concentration; a Population Pharmacokinetic Model in Non-Critical Care Saudi Patients
Aymen Ali Alqurain,1 Laila Nasser Alrashidi,2 Shatha Khalid Aloraifej,2 Moayd Alkhalifah,3 Hawra Ali Alsayed,4 Salah Abohelaika,5,6 Mohammad A Alshabeeb,7,8 Amal Shibak Aldhafeeri,9 Moyad Almuslim,10 Thuraya Nasser Bumozah,11 Mukhtar Jawad Alomar,12 Azhar Abdullah Alshehab,13 Ahmed AbdulWahab Alamer...
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| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2024-12-01
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| Series: | Drug Design, Development and Therapy |
| Subjects: | |
| Online Access: | https://www.dovepress.com/factors-affecting-vancomycin-trough-concentration-a-population-pharmac-peer-reviewed-fulltext-article-DDDT |
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| Summary: | Aymen Ali Alqurain,1 Laila Nasser Alrashidi,2 Shatha Khalid Aloraifej,2 Moayd Alkhalifah,3 Hawra Ali Alsayed,4 Salah Abohelaika,5,6 Mohammad A Alshabeeb,7,8 Amal Shibak Aldhafeeri,9 Moyad Almuslim,10 Thuraya Nasser Bumozah,11 Mukhtar Jawad Alomar,12 Azhar Abdullah Alshehab,13 Ahmed AbdulWahab Alamer,14 Jenan Al-Matouq,15 Keshore R Bidasee,16– 18 Fadhel A Alomar10 1Department of Clinical Practice, College of Pharmacy, Northern Border University, Rafha, 91911, Saudi Arabia; 2Department of Pharmacy, Mohammed Al-Mana College for Medical Sciences, Dammam, 34222, Saudi Arabia; 3Department of Neurology, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; 4Department of Pharmacy, Rashid Hospital, Dubai Academic Health Corporation, Dubai, United Arab Emirates; 5Research Department, Qatif Central Hospital, Qatif, 32654, Saudi Arabia; 6Pharmacy Department, Qatif Central Hospital, Qatif, 32654, Saudi Arabia; 7Pharmaceutical Analysis Center, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 8King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia; 9Pharmacy Department, Al Mana General Hospitals, Al-Khobar, Saudi Arabia; 10Department of Pharmacology, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, 31441, Saudi Arabia; 11Pharmacy Department, Maternity and Children Hospital in Huffuf, Al Hufuf, Saudi Arabia; 12Pharmaceutical Affair, Dammam Medical Complex, Eastern Health Cluster, Dammam, Saudi Arabia; 13Medical Supply Department, Prince Saud Bin Jalawy Hospital, Mubarraz, Saudi Arabia; 14Pharmaceutical Care Department, King Abdulaziz Hospital in Alahssa, Ministry of National Guard, Mubarraz, Saudi Arabia; 15Department of Medical Laboratory Science, Mohammed Al-Mana College for Medical Sciences, Al Safa, Dammam, 34222, Saudi Arabia; 16Department of Pharmacology and Experiment Neuroscience, University of Nebraska Medical Center, Omaha, NE, 68198, USA; 17Department of Environment and Occupational Health, University of Nebraska Medical Center, Omaha, NE, 68198, USA; 18Nebraska Redox Biology Center, Lincoln, NE, 68588, USACorrespondence: Aymen Ali Alqurain, Department of Clinical Practice, College of Pharmacy, NBU, Rafha, Saudi Arabia, Tel +966538862355, Email aymen.alqurain@nbu.edu.sa Fadhel A Alomar, Department of Pharmacology, College of Clinical Pharmacy, IAU, Dammam, Saudi Arabia, Email falomar@iau.edu.saBackground and Objective: Vancomycin is commonly prescribed in treatment of methicillin-resistant Staphylococcus aureus infections. While, vancomycins’ pharmacokinetic vary among older patients, there is a paucity of data regarding specific characteristics influencing pharmacokinetics in Saudi adult patients. This study aims to establish a population-pharmacokinetic (Pop-PK) model for vancomycin in patients admitted to medical wards, with the focus on identification of patient characteristics influencing vancomycin trough concentrations.Methods: A multicenter retrospective study was conducted involving patients aged ≥ 40 years admitted to medical wards in the Eastern Province, Saudi Arabia and initiated on vancomycin, between January to December 2022. Non-linear mixed-effects modelling (Monolix) was employed to develop the Pop-PK model. A base model was selected based on the Akaike information criterion. Covariates considered included age, sex, body weight, C-reactive protein (CRP), serum creatinine, creatinine clearance (CrCl), and albumin levels. A P-value of < 0.05 was considered statistically significant for inclusion of covariates in the final model by stepwise addition. The simulation performance of the model was assessed by visual predictive check plot. The final model was simulated using Simulx software to assess the effect of the included covariates on vancomycin trough concentration.Results: A total of 172 vancomycin trough concentrations from 124 patients were analyzed. The final Pop-PK model characterized vancomycin trough concentrations was one compartment distribution with linear elimination. CrCl and CRP were the only covariates included in the final model, as they reduced the between-subject variability (BSV) for clearance (from 173% to 81%). The simulated model demonstrated that high CRP value and low CrCl contributed to increased vancomycin trough concentrations.Conclusion: This study highlights large BSV in trough concentrations among patients and emphasizes the influencing of CrCl and CRP on vancomycin pharmacokinetics in medical care settings.Keywords: vancomycin trough concentration, C-reactive protein, creatinine clearance, population pharmacokinetics, medical care patients |
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| ISSN: | 1177-8881 |