Area under the Curve-Based Dosing of Vancomycin in Critically Ill Patients Using 6-Hour Urine Creatinine Clearance Measurement
Joint Authors
Shahrami, Bita
Najmeddin, Farhad
Ghaffari, Saeideh
Najafi, Atabak
Rouini, Mohammad Reza
Mojtahedzadeh, Mojtaba
Source
Critical Care Research and Practice
Issue
Vol. 2020, Issue 2020 (31 Dec. 2020), pp.1-6, 6 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2020-12-24
Country of Publication
Egypt
No. of Pages
6
Main Subjects
Abstract EN
Background.
The area under the curve- (AUC-) guided vancomycin dosing is the best strategy for individualized therapy in critical illnesses.
Since AUC can be calculated directly using drug clearance (CLvan), any parameter estimating CLvan will be able to achieve the goal of 24-hour AUC (AUC24 h).
The present study was aimed to determine CLvan based on 6-hour urine creatinine clearance measurement in critically ill patients with normal renal function.
Method.
23 adult critically ill patients with an estimated glomerular filtration rate (eGFR) ≥60 mL/min who received vancomycin infusion were enrolled in this pilot study.
Vancomycin pharmacokinetic parameters were determined for each patient using serum concentration data and a one-compartment model provided by MONOLIX software using stochastic approximation expectation-maximization (SAEM) algorithm.
Correlation of CLvan with the measured creatinine clearance in 6-hour urine collection (CL6 h) and estimated creatinine clearance by the Cockcroft–Gault formula (CLCG) was investigated.
Results.
Data analysis revealed that CL6 h had a stronger correlation with CLvan rather than CLCG (r = 0.823 vs.
0.594; p<0.001 vs.
0.003).
The relationship between CLvan and CL6 h was utilized to develop the following equation for estimating CLvan: CLvan (mL/min) = ─137.4 + CL6 h (mL/min) + 2.5 IBW (kg) (R2 = 0.826, p<0.001).
Regarding the described model, the following equation can be used to calculate the empirical dose of vancomycin for achieving the therapeutic goals in critically ill patients without renal impairment: total daily dose of vancomycin (mg) = (─137.4CL6-h (mL/min) + 2.5 IBW (kg)) × 0.06 AUC24 h (mg.hr/L).
Conclusion.
For AUC estimation, CLvan can be obtained by collecting urine in a 6-hour period with good approximation in critically ill patients with normal renal function.
American Psychological Association (APA)
Shahrami, Bita& Najmeddin, Farhad& Ghaffari, Saeideh& Najafi, Atabak& Rouini, Mohammad Reza& Mojtahedzadeh, Mojtaba. 2020. Area under the Curve-Based Dosing of Vancomycin in Critically Ill Patients Using 6-Hour Urine Creatinine Clearance Measurement. Critical Care Research and Practice،Vol. 2020, no. 2020, pp.1-6.
https://search.emarefa.net/detail/BIM-1138545
Modern Language Association (MLA)
Shahrami, Bita…[et al.]. Area under the Curve-Based Dosing of Vancomycin in Critically Ill Patients Using 6-Hour Urine Creatinine Clearance Measurement. Critical Care Research and Practice No. 2020 (2020), pp.1-6.
https://search.emarefa.net/detail/BIM-1138545
American Medical Association (AMA)
Shahrami, Bita& Najmeddin, Farhad& Ghaffari, Saeideh& Najafi, Atabak& Rouini, Mohammad Reza& Mojtahedzadeh, Mojtaba. Area under the Curve-Based Dosing of Vancomycin in Critically Ill Patients Using 6-Hour Urine Creatinine Clearance Measurement. Critical Care Research and Practice. 2020. Vol. 2020, no. 2020, pp.1-6.
https://search.emarefa.net/detail/BIM-1138545
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1138545