Clinical Practice Guidelines for Therapeutic Drug Monitoring of Vancomycin in the Framework of Model-Informed Precision Dosing: A Consensus Review by the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring
Background: To promote model-informed precision dosing (MIPD) for vancomycin (VCM), we developed statements for therapeutic drug monitoring (TDM). Methods: Ten clinical questions were selected. The committee conducted a systematic review and meta-analysis as well as clinical studies to establish rec...
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MDPI AG
2022-02-01
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| Online Access: | https://www.mdpi.com/1999-4923/14/3/489 |
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| author | Kazuaki Matsumoto Kazutaka Oda Kensuke Shoji Yuki Hanai Yoshiko Takahashi Satoshi Fujii Yukihiro Hamada Toshimi Kimura Toshihiko Mayumi Takashi Ueda Kazuhiko Nakajima Yoshio Takesue |
| author_facet | Kazuaki Matsumoto Kazutaka Oda Kensuke Shoji Yuki Hanai Yoshiko Takahashi Satoshi Fujii Yukihiro Hamada Toshimi Kimura Toshihiko Mayumi Takashi Ueda Kazuhiko Nakajima Yoshio Takesue |
| author_sort | Kazuaki Matsumoto |
| collection | DOAJ |
| description | Background: To promote model-informed precision dosing (MIPD) for vancomycin (VCM), we developed statements for therapeutic drug monitoring (TDM). Methods: Ten clinical questions were selected. The committee conducted a systematic review and meta-analysis as well as clinical studies to establish recommendations for area under the concentration-time curve (AUC)-guided dosing. Results: AUC-guided dosing tended to more strongly decrease the risk of acute kidney injury (AKI) than trough-guided dosing, and a lower risk of treatment failure was demonstrated for higher AUC/minimum inhibitory concentration (MIC) ratios (cut-off of 400). Higher AUCs (cut-off of 600 μg·h/mL) significantly increased the risk of AKI. Although Bayesian estimation with two-point measurement was recommended, the trough concentration alone may be used in patients with mild infections in whom VCM was administered with q12h. To increase the concentration on days 1–2, the routine use of a loading dose is required. TDM on day 2 before steady state is reached should be considered to optimize the dose in patients with serious infections and a high risk of AKI. Conclusions: These VCM TDM guidelines provide recommendations based on MIPD to increase treatment response while preventing adverse effects. |
| first_indexed | 2024-03-09T13:00:00Z |
| format | Article |
| id | doaj.art-9a2a82f4726e4a3891448d6136c9d0ac |
| institution | Directory Open Access Journal |
| issn | 1999-4923 |
| language | English |
| last_indexed | 2024-03-09T13:00:00Z |
| publishDate | 2022-02-01 |
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| record_format | Article |
| series | Pharmaceutics |
| spelling | doaj.art-9a2a82f4726e4a3891448d6136c9d0ac2023-11-30T21:55:38ZengMDPI AGPharmaceutics1999-49232022-02-0114348910.3390/pharmaceutics14030489Clinical Practice Guidelines for Therapeutic Drug Monitoring of Vancomycin in the Framework of Model-Informed Precision Dosing: A Consensus Review by the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug MonitoringKazuaki Matsumoto0Kazutaka Oda1Kensuke Shoji2Yuki Hanai3Yoshiko Takahashi4Satoshi Fujii5Yukihiro Hamada6Toshimi Kimura7Toshihiko Mayumi8Takashi Ueda9Kazuhiko Nakajima10Yoshio Takesue11Division of Pharmacodynamics, Faculty of Pharmacy, Keio University, Tokyo 105-8512, JapanDepartment of Pharmacy, Kumamoto University Hospital, Kumamoto 860-8556, JapanDivision of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo 157-8535, JapanDepartment of Pharmacy, Toho University Omori Medical Center, Tokyo 143-8541, JapanDepartment of Pharmacy, Hyogo College of Medicine, Nishinomiya 663-8501, JapanDepartment of Hospital Pharmacy, Sapporo Medical University Hospital, Sapporo 060-8543, JapanDepartment of Pharmacy, Tokyo Women’s Medical University Hospital, Tokyo 162-0054, JapanDepartment of Pharmacy, Tokyo Women’s Medical University Hospital, Tokyo 162-0054, JapanDepartment of Emergency Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka 807-8555, JapanDepartment of Infection Prevention and Control, Hyogo College of Medicine, Nishinomiya 663-8501, JapanDepartment of Infection Prevention and Control, Hyogo College of Medicine, Nishinomiya 663-8501, JapanDepartment of Infection Prevention and Control, Hyogo College of Medicine, Nishinomiya 663-8501, JapanBackground: To promote model-informed precision dosing (MIPD) for vancomycin (VCM), we developed statements for therapeutic drug monitoring (TDM). Methods: Ten clinical questions were selected. The committee conducted a systematic review and meta-analysis as well as clinical studies to establish recommendations for area under the concentration-time curve (AUC)-guided dosing. Results: AUC-guided dosing tended to more strongly decrease the risk of acute kidney injury (AKI) than trough-guided dosing, and a lower risk of treatment failure was demonstrated for higher AUC/minimum inhibitory concentration (MIC) ratios (cut-off of 400). Higher AUCs (cut-off of 600 μg·h/mL) significantly increased the risk of AKI. Although Bayesian estimation with two-point measurement was recommended, the trough concentration alone may be used in patients with mild infections in whom VCM was administered with q12h. To increase the concentration on days 1–2, the routine use of a loading dose is required. TDM on day 2 before steady state is reached should be considered to optimize the dose in patients with serious infections and a high risk of AKI. Conclusions: These VCM TDM guidelines provide recommendations based on MIPD to increase treatment response while preventing adverse effects.https://www.mdpi.com/1999-4923/14/3/489model-informed precision dosingvancomycintherapeutic drug monitoringarea under the concentration-time curveguideline |
| spellingShingle | Kazuaki Matsumoto Kazutaka Oda Kensuke Shoji Yuki Hanai Yoshiko Takahashi Satoshi Fujii Yukihiro Hamada Toshimi Kimura Toshihiko Mayumi Takashi Ueda Kazuhiko Nakajima Yoshio Takesue Clinical Practice Guidelines for Therapeutic Drug Monitoring of Vancomycin in the Framework of Model-Informed Precision Dosing: A Consensus Review by the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring Pharmaceutics model-informed precision dosing vancomycin therapeutic drug monitoring area under the concentration-time curve guideline |
| title | Clinical Practice Guidelines for Therapeutic Drug Monitoring of Vancomycin in the Framework of Model-Informed Precision Dosing: A Consensus Review by the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring |
| title_full | Clinical Practice Guidelines for Therapeutic Drug Monitoring of Vancomycin in the Framework of Model-Informed Precision Dosing: A Consensus Review by the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring |
| title_fullStr | Clinical Practice Guidelines for Therapeutic Drug Monitoring of Vancomycin in the Framework of Model-Informed Precision Dosing: A Consensus Review by the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring |
| title_full_unstemmed | Clinical Practice Guidelines for Therapeutic Drug Monitoring of Vancomycin in the Framework of Model-Informed Precision Dosing: A Consensus Review by the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring |
| title_short | Clinical Practice Guidelines for Therapeutic Drug Monitoring of Vancomycin in the Framework of Model-Informed Precision Dosing: A Consensus Review by the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring |
| title_sort | clinical practice guidelines for therapeutic drug monitoring of vancomycin in the framework of model informed precision dosing a consensus review by the japanese society of chemotherapy and the japanese society of therapeutic drug monitoring |
| topic | model-informed precision dosing vancomycin therapeutic drug monitoring area under the concentration-time curve guideline |
| url | https://www.mdpi.com/1999-4923/14/3/489 |
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