Table 3.
Summary of seven published population pharmacokinetic models of vancomycin in neonates
Model | A§ | B§ | C | D | E | F | G |
---|---|---|---|---|---|---|---|
Reference | Anderson et al., 2007 [8] | Allegaert et al., 2007 [9] | Kimura et al., 2004 [10] | Lo et al., 2010 [11] | Marqués-Miñana et al., 2010 [12] | > Grimsley et al., 1999 [17] | Capparelli et al., 2001 [13] |
Patients | Premature neonates (PMA range 24–34 weeks) | Premature neonates (median PMA of 28 weeks, range 24–30 weeks) | Neonates and infants (PMA range 25.1–48.4 weeks) | Premature neonates (median PMA of 30 weeks; range 23.6–34 weeks) | Neonates and infants (PMA range 25.1–48.1 week) | Neonates and infants(GA range 25–41 weeks; PNA range 2–76 days) | Neonates and infants (GA 33.5 ± 6 weeks; PNA 70 ± 100 days) |
Dosing regimen | PNA 1–7 days/serum creatinine value >71 μmol l−1: 15 mg kg−1 every 12 h | PNA 1–7 days/serum creatinine value >71 μmol l−1: 15 mg kg−1 every 12 h | PNA 1–7 days: 15 mg kg−1 every 12 h | See attached Table 3S1 | See attached Table 3S2 | 15 mg kg−1 every 24 h – 15 mg kg−1 every 8 h | 15 mg kg−1 every 24 h – 15 mg kg−1 every 12 h |
PNA > 7 days: 15 mg kg−1 every 8 h | PNA > 7 days: 15 mg kg−1 every 8 h | PNA > 7 days: 15 mg kg−1 every 8 h | |||||
Number of patients | 214 | 249 | 19 | 116 | 111 (70 in building group and 41 in validation group) | 59 | 374 |
Number of samples | 604 | 648 | 88 | 835 | – | 347 | 1103 |
Sampling times | Trough and peak | Combination of sparse and intensive PK sampling | |||||
Structure model | One compartment model with first order elimination | Two compartment model with first-order elimination | |||||
Tested covariates | Weight, PMA, PNA, renal function, positive blood culture, positive ventilation, inotrope, NSAID, maternal betamethasone administration | Weight, PMA, SGA, renal function, NCOX, maternal betamethasone administration | Weight, PCA, PNA, GA, Apgar score, serum creatinine | Weight, PMA, PNA, SGA, serum creatinine, race, ventilation, NSAID | Weight, birth weight, PMA, PNA, GA, height, urine output, BSA, gender, concomitant drugs | Weight, PCA, GA, serum creatinine, nutrition, | Weight, PNA, GA, gender, serum creatinine, apgar5 score, ECMO |
Significant covariate on CL | Weight, PMA, renal function*, positive pressure ventilation | Weight, PMA, renal function*, non-selective NSAIDs, SGA | Weight, PCA, serum creatinine | Weight, PMA, SGA | Weight, PMA, amoxicillin-clavulanic acid | Weight, serum creatinine | Weight, PNA, GA, serum creatinine |
CL formula | 3.83 × (weight/70)0.75 × (PMA3.68/(PMA3.68 + 33.33.68)) × (516 × EXP (0.00823 × ((PMA − 40)/52 − 40))/serum creatinine)/6) × Fventilation | 1.58 × (weight/70)0.75 × (EXP(0.0456 × (PMA − 30))) × )) × (516 × EXP (0.00766 × ((PMA − 30)/52 − 40))/serum creatinine)/6) × FSGA × FNCOX | 0.0323 × weight/Serum creatinine (PCA ≥ 34 weeks) | CL = 1.0 × (weight/70)0.75 × (PMA/30)3.16 × (FSGA) | 0.00192 × PMA × (1 + 0.65 × amoxicillin-clavulanic acid) × weight | 3.56 × weigh/serum creatinine | Weight × (0.028/serum creatinine + 0.000127 × PNA + FGA) + 0.006 |
0.025 × weight/serum creatinine (PCA < 34 weeks) | |||||||
Significant covariate on V | Weight, inotropic drugs | Weight | Weight | Weight | Weight, spironolactone | Weight | Weight |
V formula | 39.4 × (weight/70) × Finotrope | 39.3 × (weight/70) | 0.66 × weight | 36.6 × (weight/70) | 0.572 × (1 − 0.344 × spironolactone) × weight | 0.669 × weight | Vss = 0.793 × weight + 0.01 |
Vc = 0.0334 × weight | |||||||
Validation method | Basic goodness-of-fit plots, Bootstrapping | Basic goodness-of-fit plots | Basic goodness-of-fit plots, Bootstrapping | Basic goodness-of-fit plots, Bootstrapping, Box-plots | Basic goodness-of-fit plots, Bootstrapping, Visual predictive check | Basic goodness-of-fit plots | Basic goodness-of-fit plots, external evaluation |
Vancomycine analytical method | PETINIA on Dimension | PETINIA on Dimension | FPIA on TDx | FPIA on Cobas Integra | FPIA on TDx | FPIA on TDx | EMIT and FPIA |
Serum creatinine method | Jaffé | Jaffé | Enzymatic | Jaffé | † | Jaffé | Jaffé |