Optimal vancomycin dosing regimens for critically ill patients with acute kidney injury during continuous renal replacement therapy: A Monte Carlo simulation study

Last modified: August 30, 2019
You are here:
Estimated reading time: 1 min
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:

Tags:
Was this article helpful?
Dislike 0
Views: 23