Vancomycin pharmacokinetics in a patient population: effect of age, gender, and body weight.

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  • Additional Information
    • Source:
      Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 7909660 Publication Model: Print Cited Medium: Print ISSN: 0163-4356 (Print) Linking ISSN: 01634356 NLM ISO Abbreviation: Ther Drug Monit Subsets: MEDLINE
    • Publication Information:
      Publication: Hagerstown, MD : Lippincott Williams & Wilkins
      Original Publication: [New York] Raven Press.
    • Subject Terms:
      Aging/*metabolism ; Body Weight/*physiology ; Vancomycin/*pharmacokinetics; Adult ; Aged ; Dose-Response Relationship, Drug ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Sex Factors ; Vancomycin/blood
    • Abstract:
      The effects of age, gender, and body weight on the pharmacokinetics of vancomycin were examined using data collected as part of routine therapeutic drug monitoring in patients. One thousand eighty-five sets of steady-state peak and trough serum concentrations obtained from 704 different patients were used to calculate elimination rate constant (k), volume of distribution (V), and clearance (Cl) using a one-compartment model. The median half-life of vancomycin was 6.5 h. Clearance was significantly correlated with creatinine clearance as estimated using the Cockcroft-Gault equation [Cl = 0.771 (Clcr) + 18.9; r = 0.63]. V averaged 0.69 L/kg ideal body weight (IBW) with increased values in females, patients over age 60, and obese patients. V ranged from 0.58 L/kg IBW in normal weight males under age 40 to 1.17 L/kg IBW in obese females over age 60. V was not different in underweight patients and those of normal weight (43.8 vs. 44.4 L). Regression analysis indicated that V was more predictable in women than in men and that vancomycin distributed into excess body weight (EBW) to a greater extent in women. However, the correlation coefficients from multiple regression analysis of V with IBW, EBW, and age did not exceed 0.60, and the high root mean square error values of 11-15 L suggest considerable variability in V is not accounted for by these factors alone. Despite these limitations, dosing of vancomycin may be improved by adjusting initial estimates of V for patient age, gender, and obesity.
    • Accession Number:
      6Q205EH1VU (Vancomycin)
    • Publication Date:
      Date Created: 19941001 Date Completed: 19950308 Latest Revision: 20190904
    • Publication Date:
      20240829
    • Accession Number:
      10.1097/00007691-199410000-00013
    • Accession Number:
      7846752