Pharmacokinetics of Vancomycin among Patients with Chemotherapy-Associated Febrile Neutropenia: Which Would Be the Best Dosing to Obtain Appropriate Exposure?
Previous research has determined that the required doses for treating febrile neutropenia with vancomycin are higher than the doses used conventionally. These recommendations have been made considering pharmacotherapeutic goals based on minimum concentration (<inline-formula><math xmlns=&qu...
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MDPI AG
2022-11-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/11/11/1523 |
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| author | Daniel Parra González Jefferson Alejandro Pérez Mesa Sonia Isabel Cuervo Maldonado Jorge Augusto Díaz Rojas Jorge Alberto Cortés Edelberto Silva Gómez Carlos Humberto Saavedra Trujillo Julio Gómez |
| author_facet | Daniel Parra González Jefferson Alejandro Pérez Mesa Sonia Isabel Cuervo Maldonado Jorge Augusto Díaz Rojas Jorge Alberto Cortés Edelberto Silva Gómez Carlos Humberto Saavedra Trujillo Julio Gómez |
| author_sort | Daniel Parra González |
| collection | DOAJ |
| description | Previous research has determined that the required doses for treating febrile neutropenia with vancomycin are higher than the doses used conventionally. These recommendations have been made considering pharmacotherapeutic goals based on minimum concentration (<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mi mathvariant="normal">C</mi><mi>min</mi></msub></semantics></math></inline-formula>) between 15–20 <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mi>mg</mi><mo>/</mo><mi mathvariant="normal">L</mi></mrow></semantics></math></inline-formula>. This study was developed to evaluate dose recommendations based on the achievement of a target consisting of ratio of area under the curve over minimum inhibitory concentration (<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><msub><mi>AUC</mi><mrow><mn>24</mn><mi mathvariant="normal">h</mi></mrow></msub><mo>/</mo><mi>MIC</mi></mrow></semantics></math></inline-formula>) <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mo>≥</mo><mn>400</mn></mrow></semantics></math></inline-formula> in this population of individuals. This study was conducted in a referral hospital for cancer treatment, study participants received vancomycin doses of <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mn>1</mn><mi mathvariant="normal">g</mi></mrow></semantics></math></inline-formula> every 12 h in 2-4-h infusions. Vancomycin was described by a two-compartment pharmacokinetic model with clearance dependent on the estimated glomerular filtration rate. Simulations were performed taking into account a reduced version of the model to establish the influence of controllable and non-controllable variables on the probability of achieving several PK-PD targets. A dose of <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mn>2.5</mn><mspace width="3.33333pt"></mspace><mi mathvariant="normal">g</mi><mo>/</mo><mi>day</mi></mrow></semantics></math></inline-formula> in patients with estimated glomerular filtration rate (<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mi>eGFR</mi></semantics></math></inline-formula>) between 80 and <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mn>122</mn><mspace width="3.33333pt"></mspace><mi>mL</mi><mo>/</mo><mi>min</mi><mo>/</mo><mn>1.73</mn><mspace width="3.33333pt"></mspace><msup><mi mathvariant="normal">m</mi><mn>2</mn></msup></mrow></semantics></math></inline-formula> was adequate to achieve the pharmacotherapeutic target. A discrepancy was found between <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mi>AUC</mi></semantics></math></inline-formula>-based and <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mi mathvariant="normal">C</mi><mi>min</mi></msub></semantics></math></inline-formula>-based PK/PD indices, the former being affected by the dose and creatinine clearance while the latter highly influenced by the interval between doses. |
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| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-09T19:20:15Z |
| publishDate | 2022-11-01 |
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| spelling | doaj.art-9335bbe8f83f414c81bfe432641285942023-11-24T03:27:47ZengMDPI AGAntibiotics2079-63822022-11-011111152310.3390/antibiotics11111523Pharmacokinetics of Vancomycin among Patients with Chemotherapy-Associated Febrile Neutropenia: Which Would Be the Best Dosing to Obtain Appropriate Exposure?Daniel Parra González0Jefferson Alejandro Pérez Mesa1Sonia Isabel Cuervo Maldonado2Jorge Augusto Díaz Rojas3Jorge Alberto Cortés4Edelberto Silva Gómez5Carlos Humberto Saavedra Trujillo6Julio Gómez7Department of Pharmacy, Faculty of Sciences, Universidad Nacional de Colombia, Bogotá 111321, ColombiaFaculty of Medicine, Universidad Nacional de Colombia, Bogotá 111321, ColombiaFaculty of Medicine, Universidad Nacional de Colombia, Bogotá 111321, ColombiaDepartment of Pharmacy, Faculty of Sciences, Universidad Nacional de Colombia, Bogotá 111321, ColombiaFaculty of Medicine, Universidad Nacional de Colombia, Bogotá 111321, ColombiaDepartment of Pharmacy, Faculty of Sciences, Universidad Nacional de Colombia, Bogotá 111321, ColombiaFaculty of Medicine, Universidad Nacional de Colombia, Bogotá 111321, ColombiaGrupo de Investigación en Enfermedades Infecciosas en Cáncer y Alteraciones Hematológicas (GREICAH), Universidad Nacional de Colombia, Bogotá 111321, ColombiaPrevious research has determined that the required doses for treating febrile neutropenia with vancomycin are higher than the doses used conventionally. These recommendations have been made considering pharmacotherapeutic goals based on minimum concentration (<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mi mathvariant="normal">C</mi><mi>min</mi></msub></semantics></math></inline-formula>) between 15–20 <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mi>mg</mi><mo>/</mo><mi mathvariant="normal">L</mi></mrow></semantics></math></inline-formula>. This study was developed to evaluate dose recommendations based on the achievement of a target consisting of ratio of area under the curve over minimum inhibitory concentration (<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><msub><mi>AUC</mi><mrow><mn>24</mn><mi mathvariant="normal">h</mi></mrow></msub><mo>/</mo><mi>MIC</mi></mrow></semantics></math></inline-formula>) <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mo>≥</mo><mn>400</mn></mrow></semantics></math></inline-formula> in this population of individuals. This study was conducted in a referral hospital for cancer treatment, study participants received vancomycin doses of <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mn>1</mn><mi mathvariant="normal">g</mi></mrow></semantics></math></inline-formula> every 12 h in 2-4-h infusions. Vancomycin was described by a two-compartment pharmacokinetic model with clearance dependent on the estimated glomerular filtration rate. Simulations were performed taking into account a reduced version of the model to establish the influence of controllable and non-controllable variables on the probability of achieving several PK-PD targets. A dose of <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mn>2.5</mn><mspace width="3.33333pt"></mspace><mi mathvariant="normal">g</mi><mo>/</mo><mi>day</mi></mrow></semantics></math></inline-formula> in patients with estimated glomerular filtration rate (<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mi>eGFR</mi></semantics></math></inline-formula>) between 80 and <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mn>122</mn><mspace width="3.33333pt"></mspace><mi>mL</mi><mo>/</mo><mi>min</mi><mo>/</mo><mn>1.73</mn><mspace width="3.33333pt"></mspace><msup><mi mathvariant="normal">m</mi><mn>2</mn></msup></mrow></semantics></math></inline-formula> was adequate to achieve the pharmacotherapeutic target. A discrepancy was found between <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mi>AUC</mi></semantics></math></inline-formula>-based and <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mi mathvariant="normal">C</mi><mi>min</mi></msub></semantics></math></inline-formula>-based PK/PD indices, the former being affected by the dose and creatinine clearance while the latter highly influenced by the interval between doses.https://www.mdpi.com/2079-6382/11/11/1523pharmacokineticsvancomycinchemotherapy-induced febrile neutropeniahematologic neoplasmstherapeutic drug monitoringarea under curve |
| spellingShingle | Daniel Parra González Jefferson Alejandro Pérez Mesa Sonia Isabel Cuervo Maldonado Jorge Augusto Díaz Rojas Jorge Alberto Cortés Edelberto Silva Gómez Carlos Humberto Saavedra Trujillo Julio Gómez Pharmacokinetics of Vancomycin among Patients with Chemotherapy-Associated Febrile Neutropenia: Which Would Be the Best Dosing to Obtain Appropriate Exposure? Antibiotics pharmacokinetics vancomycin chemotherapy-induced febrile neutropenia hematologic neoplasms therapeutic drug monitoring area under curve |
| title | Pharmacokinetics of Vancomycin among Patients with Chemotherapy-Associated Febrile Neutropenia: Which Would Be the Best Dosing to Obtain Appropriate Exposure? |
| title_full | Pharmacokinetics of Vancomycin among Patients with Chemotherapy-Associated Febrile Neutropenia: Which Would Be the Best Dosing to Obtain Appropriate Exposure? |
| title_fullStr | Pharmacokinetics of Vancomycin among Patients with Chemotherapy-Associated Febrile Neutropenia: Which Would Be the Best Dosing to Obtain Appropriate Exposure? |
| title_full_unstemmed | Pharmacokinetics of Vancomycin among Patients with Chemotherapy-Associated Febrile Neutropenia: Which Would Be the Best Dosing to Obtain Appropriate Exposure? |
| title_short | Pharmacokinetics of Vancomycin among Patients with Chemotherapy-Associated Febrile Neutropenia: Which Would Be the Best Dosing to Obtain Appropriate Exposure? |
| title_sort | pharmacokinetics of vancomycin among patients with chemotherapy associated febrile neutropenia which would be the best dosing to obtain appropriate exposure |
| topic | pharmacokinetics vancomycin chemotherapy-induced febrile neutropenia hematologic neoplasms therapeutic drug monitoring area under curve |
| url | https://www.mdpi.com/2079-6382/11/11/1523 |
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