Predicting the Area under the Plasma Concentration-Time Curve (AUC) for First Dose Vancomycin Using First-Order Pharmacokinetic Equations
To treat critically ill patients, early achievement of the target area under the plasma concentration-time curve/minimum inhibitory concentration (AUC/MIC) in the first 24 h is recommended. However, accurately calculating the AUC before steady state is an obstacle to this goal. A first-order pharmac...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-03-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/12/4/630 |
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| author | Kritsaporn Sujjavorakul Wasan Katip Stephen J. Kerr Noppadol Wacharachaisurapol Thanyawee Puthanakit |
| author_facet | Kritsaporn Sujjavorakul Wasan Katip Stephen J. Kerr Noppadol Wacharachaisurapol Thanyawee Puthanakit |
| author_sort | Kritsaporn Sujjavorakul |
| collection | DOAJ |
| description | To treat critically ill patients, early achievement of the target area under the plasma concentration-time curve/minimum inhibitory concentration (AUC/MIC) in the first 24 h is recommended. However, accurately calculating the AUC before steady state is an obstacle to this goal. A first-order pharmacokinetic equation to calculate vancomycin AUC after a first dose of vancomycin has never been studied. We sought to estimate AUC using two first-order pharmacokinetic equations, with different paired concentration time points, and to compare these to the actual first dose vancomycin AUC calculated by the linear-log trapezoid rule as a reference. The equations were validated using two independent intensive first dose vancomycin concentration time data sets, one from 10 adults and another from 14 children with severe infection. The equation with compensation for the alpha distribution phase using a first vancomycin serum concentration from 60 to 90 min and the second concentration from 240 to 300 min after the completed infusion showed good agreement and low bias of calculated AUC, with mean differences <5% and Lin’s correlation coefficient >0.96. Moreover, it gave an excellent correlation with Pearson’s r > 0.96. Estimating the first dose vancomycin AUC calculated using this first-order pharmacokinetic equation is both reliable and reproducible in clinical practice settings. |
| first_indexed | 2024-03-11T05:18:56Z |
| format | Article |
| id | doaj.art-69f8fe95d1994784b7f63507ee13940c |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-11T05:18:56Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-69f8fe95d1994784b7f63507ee13940c2023-11-17T18:01:44ZengMDPI AGAntibiotics2079-63822023-03-0112463010.3390/antibiotics12040630Predicting the Area under the Plasma Concentration-Time Curve (AUC) for First Dose Vancomycin Using First-Order Pharmacokinetic EquationsKritsaporn Sujjavorakul0Wasan Katip1Stephen J. Kerr2Noppadol Wacharachaisurapol3Thanyawee Puthanakit4Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, ThailandDepartment of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, ThailandBiostatistics Centre, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, ThailandCenter of Excellence in Clinical Pharmacokinetics and Pharmacogenomics, Department of Pharmacology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, ThailandDepartment of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, ThailandTo treat critically ill patients, early achievement of the target area under the plasma concentration-time curve/minimum inhibitory concentration (AUC/MIC) in the first 24 h is recommended. However, accurately calculating the AUC before steady state is an obstacle to this goal. A first-order pharmacokinetic equation to calculate vancomycin AUC after a first dose of vancomycin has never been studied. We sought to estimate AUC using two first-order pharmacokinetic equations, with different paired concentration time points, and to compare these to the actual first dose vancomycin AUC calculated by the linear-log trapezoid rule as a reference. The equations were validated using two independent intensive first dose vancomycin concentration time data sets, one from 10 adults and another from 14 children with severe infection. The equation with compensation for the alpha distribution phase using a first vancomycin serum concentration from 60 to 90 min and the second concentration from 240 to 300 min after the completed infusion showed good agreement and low bias of calculated AUC, with mean differences <5% and Lin’s correlation coefficient >0.96. Moreover, it gave an excellent correlation with Pearson’s r > 0.96. Estimating the first dose vancomycin AUC calculated using this first-order pharmacokinetic equation is both reliable and reproducible in clinical practice settings.https://www.mdpi.com/2079-6382/12/4/630vancomycintherapeutic drug monitoringpharmacokineticsarea under the concentration curvecritically ill patients |
| spellingShingle | Kritsaporn Sujjavorakul Wasan Katip Stephen J. Kerr Noppadol Wacharachaisurapol Thanyawee Puthanakit Predicting the Area under the Plasma Concentration-Time Curve (AUC) for First Dose Vancomycin Using First-Order Pharmacokinetic Equations Antibiotics vancomycin therapeutic drug monitoring pharmacokinetics area under the concentration curve critically ill patients |
| title | Predicting the Area under the Plasma Concentration-Time Curve (AUC) for First Dose Vancomycin Using First-Order Pharmacokinetic Equations |
| title_full | Predicting the Area under the Plasma Concentration-Time Curve (AUC) for First Dose Vancomycin Using First-Order Pharmacokinetic Equations |
| title_fullStr | Predicting the Area under the Plasma Concentration-Time Curve (AUC) for First Dose Vancomycin Using First-Order Pharmacokinetic Equations |
| title_full_unstemmed | Predicting the Area under the Plasma Concentration-Time Curve (AUC) for First Dose Vancomycin Using First-Order Pharmacokinetic Equations |
| title_short | Predicting the Area under the Plasma Concentration-Time Curve (AUC) for First Dose Vancomycin Using First-Order Pharmacokinetic Equations |
| title_sort | predicting the area under the plasma concentration time curve auc for first dose vancomycin using first order pharmacokinetic equations |
| topic | vancomycin therapeutic drug monitoring pharmacokinetics area under the concentration curve critically ill patients |
| url | https://www.mdpi.com/2079-6382/12/4/630 |
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