| Research Article: | Optimal vancomycin dosing regimens for critically ill patients with acute kidney injury during continuous renal replacement therapy: A Monte Carlo simulation study |
| ผู้เขียน/Author: | Taniya Charoensareerat, Weerachai Chaijamorn, Apinya Boonpeng, Nattachai Srisawat, Chalermsri Pummangura & Sutthiporn Pattharachayakul |
| Email: | taniya.cha@siam.edu |
| Department/Faculty | Faculty of Pharmacy, Siam University, Bangkok 10160 |
| Published/แหล่งเผยแพร่ | Journal of Critical Care, 54, 77-82. |
การอ้างอิง/citation
Taniya Charoensareerat, Weerachai Chaijamorn, Apinya Boonpeng, Apinya Boonpeng, Chalermsri Pummangura & Sutthiporn Pattharachayakul. (2019). Optimal vancomycin dosing regimens for critically ill patients with acute kidney injury during continuous renal replacement therapy: A Monte Carlo simulation study. Journal of Critical Care, 54, 77-82.
ABSTRACT
Purpose: This study aims to determine the optimal vancomycin dosing in critically ill patients with acute kidney injury receiving continuous renal replacement therapy (CRRT) using Monte Carlo simulation.
Methods: A one-compartment pharmacokinetic model was conducted to define vancomycin deposition for the initial 48hours of therapy. Pharmacokinetic parameters were gathered from previously published studies. The AUC24/MIC ratio of at least 400 and an average of AUC0-24 at N 700mgh/L was utilized to evaluate efficacy and nephrotoxicity, respectively. The doses achieved at least 90% of the probability of target attainment (PTA) with the lowest risk of nephrotoxicity defined as the optimal dose. Results: The regimens of 1.75grams every 24hours and 1.5grams loading followed by 500mg every 8hours were recommended for empirical therapy of an MRSA infection with expected MIC ≤1mg/L, and definite therapy with actual MIC of 1mg/L. The probabilities of nephrotoxic results from these regimens were 35%. Conclusions: A higher dose of vancomycin than the current literature-based recommendation was needed in CRRT patients.
Keywords: vancomycin continuous renal replacement therapy Monte Carlo simulations critically ill acute kidney injury.
Optimal vancomycin dosing regimens for critically ill patients with acute kidney injury during continuous renal replacement therapy: A Monte Carlo simulation study
Faculty of Pharmacy, Siam University, Bangkok, Thailand
Related:
- The effect of direct hemoperfusion with polymyxin B immobilized cartridge on meropenem in critically ill patients requiring renal support
- Design and characterization of electrospun shellac-polyvinylpyrrolidone blended micro/nanofibres loaded with monolaurin for application in wound healing
- General Knowledge for Pharmacists in Children Hematopoietic Stem Cell Transplantation
- Doripenem dosing in Asian critically ill patients with continuous renal replacement therapy
- Development of Nanoemulsions containing coconut oil with mixed emulsifiers: Effect of mixing speed on physical properties
- Doripenem dosing regimens in Asian critically ill patients with continuous real replacement therapy
- Optimal vancomycin dosing regimens for critically ill patients with acute kidney injury during continuous renal replacement therapy: A Monte Carlo simulation study