Predictability of reported population pharmacokinetic models of vancomycin in Chinese adult patients

来源 :第四届定量药理学与新药评价国际会议·2013(The 4th International Symposium in Qu | 被引量 : 0次 | 上传用户:xsw2233
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  Objective: There are numerous studies on population pharmacokinetics of vancomycin in adult patients.However, there is no such research for Chinese adult patients.This study was conducted to evaluate the predictive performance of reported population pharmacokinetic models of vancomycin in Chinese adult patients and identify some models appropriate for our database.Methods: A literature search was conducted in PubMed to obtain the population pharmacokinetic models of vancomyein published between December 2010 and September 2012.The models were assessed by concentration data collected from Chinese patients through extemal validation.Models with relatively poor predictability were excluded from further analysis.The performance of the remaining models was evaluated in patients with different levels of creatinine clearance, age, body weight and sex by Bayesian method.This method was also used to compare the predictive performance based on peak concentration with trough concentration and the predictability based on different number of observed concentrations.Results: One hundred and sixty-five retrospective concentrations from 72 Chinese adult patients were collected as the external dataset.The evaluated models included seven publications in the review of Marsot et al.and three other studies published after December 2010.Three models with poor performance on external validation were excluded from the next Bayesian analysis.The distribution of covariates in the model-building dataset had an important effect on prediction.The predictability based on peak/trough concentration was similar among the evaluated models and no significant difference was found in our dataset except for Roberts model.The increased number of samples improved the performance in Bayesian process.Conclusion: The performance of external evaluation varied among the evaluated models.The patient population and distribution of covariates should be given more consideration when a model is chosen to perform target concentration intervention.The model developed by Purwonugroho et al.built on a dataset similar to our database is appropriate for target concentration intervention of vancomycin therapy in Chinese adult patients.
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