http://www.jcps.ac.cn

Journal of Chinese Pharmaceutical Sciences ›› 2020, Vol. 29 ›› Issue (4): 260-271.DOI: 10.5246/jcps.2020.04.025

• Original articles • Previous Articles     Next Articles

Population pharmacokinetics of vancomycin in Chinese elderly patients and its application for dose individualisation

Jin Zhang1,2#, Weiwei Lin1#, Wei Wu1, Xianzhong Guo1, Pinfang Huang1, Xinhua Lin4, Zheng Jiao3*, Changlian Wang1*   

  1. 1. Department of Pharmacy, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian, China
    2. Department of Pharmacy, Union Hospital, Fujian Medical University, Fuzhou 350001, Fujian, China
    3. Department of Pharmacy, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai 200030, China
    4. The School of Pharmacy, Fujian Medical University, Fuzhou 350108, Fujian, China
  • Received:2019-12-25 Revised:2020-02-28 Online:2020-04-30 Published:2020-03-12
  • Contact: Tel.: +86-591-87981331; +86-21-2220000 ext 3051, E-mail: wcl007@126.com; jiaozhen@online.sh.cn
  • Supported by:
    Guidance Project of Fujian Science and Technology Department (Grant No. 2017Y0033); Fujian Medical Innovation Project (Grant No. 2017-CX-31); Sail Project of Fujian Medical University (Grant No. 2017XQ1068); “Weak Discipline Construction Project” of Shanghai Municipal Commission of Health and Family Planning (Grant No. 2016ZB0301-01).

Abstract:

In the present study, we aimed to develop a population pharmacokinetics (PPK) model of vancomycin (VCM) and proposethe individualised dosage regimen for Chinese elderly patients. The data were collected prospectively from Chinese elderly patients receiving VCM therapy. Steady-state trough concentrations of VCM were determined using an enzyme-multiplied immunoassay. Patients’ sex, age, body weight, concomitant medications, infection type, and laboratory findingswere recorded. The PPK model was developed using nonlinear mixed-effects model software. Moreover, we used Monte Carlo simulations to develop an initial dosage regimen targeting various VCM through concentration ranges based on the final model. We found that VCM clearance (CL) was significantly influenced by post-craniotomy meningitis (PCM) and glomerular filtration rate in elderly patients. Additionally, a new dosage regimen was proposed to individualise VCM regimen for PCM and non-PCM elderly patients. A PPK model was established to estimate the individual VCM CL for elderly patients, which could be applied for individualising doses in the target population.

Key words: Elderly patient, Population pharmacokinetics, Post-craniotomy meningitis, Vancomycin, Dose individualisation

CLC Number: 

Supporting: