External Validation of Obese/Critically Ill Vancomycin Population Pharmacokinetic Models in Critically Ill Patients Who Are Obese.

Publisher: Wiley Country of Publication: England NLM ID: 0366372 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1552-4604 (Electronic) Linking ISSN: 00912700 NLM ISO Abbreviation: J Clin Pharmacol Subsets: MEDLINE

Publication: 2013- : Oxford : Wiley
Original Publication: Stamford, Conn., Hall Associates.

Vancomycin*/pharmacokinetics ; Anti-Infective Agents*; Adult ; Humans ; Critical Illness ; Retrospective Studies ; Obesity/drug therapy ; Anti-Bacterial Agents/pharmacokinetics

Obesity combined with critical illness might increase the risk of acquiring infections and hence mortality. In this patient population the pharmacokinetics of antimicrobials vary significantly, making antimicrobial dosing challenging. The objective of this study was to assess the predictive performance of published population pharmacokinetic models of vancomycin in patients who are critically ill or obese for a cohort of critically ill patients who are obese. This was a multi-center retrospective study conducted at 2 hospitals. Adult patients with a body mass index of ≥30 kg/m ² were included. PubMed was searched for published population pharmacokinetic studies in patients who were critically ill or obese. External validation was performed using Monolix software. A total of 4 models were identified in patients who were obese and 5 models were identified in patients who were critically ill. In total, 138 patients who were critically ill and obese were included, and the most accurate models for these patients were the Goti and Roberts models. In our analysis, models in patients who were critically ill outperformed models in patients who were obese. When looking at the most accurate models, both the Goti and the Roberts models had patient characteristics similar to ours in terms of age and creatinine clearance. This indicates that when selecting the proper model to apply in practice, it is important to account for all relevant variables, besides obesity.
(© 2023, The American College of Clinical Pharmacology.)

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Keywords: critical care; external validation; model-informed precision dosing; obesity; pharmacokinetics; therapeutic drug monitoring; vancomycin

6Q205EH1VU (Vancomycin)
0 (Anti-Infective Agents)
0 (Anti-Bacterial Agents)

Date Created: 20231020 Date Completed: 20240228 Latest Revision: 20240422

20240422

10.1002/jcph.2375

37862131