Development of a model to predict vancomycin serum concentration during continuous infusion of vancomycin in critically ill pediatric patients

• 발행기관: 대한생리학회-대한약리학회
• 저자명: Yu Jin Han Wonjin Jang Jung Sun Kim Hyun Jeong Kim Sung Yun Suh Yoon Sook Cho June Dong Park Bongjin Lee
• 간행물 정보: 『The Korean Journal of Physiology & Pharmacology』제28권 제2호, 121~127쪽, 전체 7쪽
• 주제분류: 의약학 > 의학일반
• 파일형태: PDF
• 발행일자: 2024.03.01

국문 초록

Vancomycin is a frequently used antibiotic in intensive care units, and the patient’s renal clearance affects the pharmacokinetic characteristics of vanco-mycin. Several advantages have been reported for vancomycin continuous intrave-nous infusion, but studies on continuous dosing regimens based on patients’ renal clearance are insufficient. The aim of this study was to develop a vancomycin serum concentration prediction model by factoring in a patient’s renal clearance. Children admitted to our institution between July 1, 2021, and July 31, 2022 with records of continuous infusion of vancomycin were included in the study. Sex, age, height, weight, vancomycin dose by weight, interval from the start of vancomycin adminis-tration to the time of therapeutic drug monitoring sampling, and vancomycin serum concentrations were analyzed with the linear regression analysis of the mixed effect model. Univariable regression analysis was performed using the vancomycin serum concentration as a dependent variable. It showed that vancomycin dose (p < 0.001) and serum creatinine (p = 0.007) were factors that had the most impact on vancomy-cin serum concentration. Vancomycin serum concentration was affected by vanco-mycin dose (p < 0.001) and serum creatinine (p = 0.001) with statistical significance, and a multivariable regression model was obtained as follows: Vancomycin serum concentration (mg/l) = –1.296 + 0.281 × vancomycin dose (mg/kg) + 20.458 × serum creatinine (mg/dl) (adjusted coefficient of determination, R2 = 0.66). This prediction model is expected to contribute to establishing an optimal continuous infusion regi-men for vancomycin.

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INTRODUCTION

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키워드

Intravenous infusions Pediatric intensive care units Pharmacokinetics Vancomycin