Table 4.
Author (Year) | Country | Study Design | Characteristics of Patients Included | Patients with Neutropenia (%) | Sample Size | Number of serum Concentrations | Age | Gender (M/F) | Weight (kg) | Renal Function | Vancomycin Dosing | Timing of Vancomycin Sampling | Pharmacokinetic Modeling Method | Model | Pharmacokinetic Parameters | |||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
V | CL | Ke (h−1) | t1/2 (h) | |||||||||||||||
Pharmacokinetic analysis | ||||||||||||||||||
Kureishi 199026 | Canada | Single-center prospective study | Patients with acute leukemia and had absolute granulocyte below 500/mm3 | 100% | 25 | NR | NR | NR | NR | NR | Intermittent infusion; 15 mg/kg q12h | Prior to infusion and at 1 and 3 h post-infusion daily during the first 3 days and every 3 to 7 days thereafter | Equations with two steady-state samples | One-compartment model | 0.61 ± 0.21 L/kg | NR | NR | 5.6 ± 1.8 |
Le Normand 199428 | France | Single-center prospective study | Patients with hematologic malignancies who were neutropenic (100/mm3) | 100% | 10 | 130 | 36.2 (range: 18–50) | 4/6 | 64.6 ± 10.4 | 141.2 ± 36.2 mL/min | Intermittent infusion; 1000 mg every 12 h |
The first dose: prior to injection, at the end of the infusion, and 11 samples collected until 11 h after the end of the infusion | G-Pharm computer program | Two-compartment model | Vc: 22.9 ± 11.4 L | 158 ± 51 mL/min | NR | 2.94 ± 0.84 |
Jarkowski 201127 | United states | Single-center prospective study | Acute myeloid leukemia patients receiving vancomycin | NR | 25 | NR | 59.12 ± 16.26 | 17/8 | 86.05 ± 19.42 | 85.72 ± 37.28 mL/min/1.73m2 | Intermittent infusion; 1970.00 ± 605.19 mg/d | Three samples: 1 h, 3–8 h, and 8–24 h post-infusion | Maximum a priori Bayesian estimation using Adapt 5 | Two-compartment model | Vc: 0.23 L/kg Vss: 0.60 L/kg |
0.14 L/h/kg | NR | NR |
Ghehi 201320 | Iran | Single-center prospective study | Patients with neutropenic fever after HSCT | 100% | 20 | 40 | 29.9 ± 9.5 | NR | 72.5 ± 15.2 (ABW) | 104.7 ± 37.0 mL/min | Intermittent infusion; 31.9 (±10.5) mg/kg/d (69.6%:1g q12h; 17.4%:1g q8h) | First steady-state trough (within 30 minutes prior to the fourth dose), peak concentration, random sample | Equations with two steady-state samples | One-compartment model | 0.60 (0.44–0.76) L/kg | 0.090 (0.071–0.109) L/h/kg 109.7 (82.7–136) mL/min | 0.16 (0.13–0.19) | 4.9 (3.8–6.0) |
Population pharmacokinetic model | ||||||||||||||||||
Buelga 200529 | Spain | Single-center retrospective study | Adult inpatients with an underlying hematologic malignancy | 43.7% | 215 | 1004 | 51.5 ± 15.9 | 119/96 | 64.7 ± 11.3 | 89.4 ± 39.2 mL/min | Intermittent infusion | Blood sampling was ordered as required clinically | Nonlinear mixed-effect modeling approach (NONMEM) | One-compartment model | CL (L/h): 1.08 × CLCR (Cockcroft and Gault) (L/h); CVCL: 28.16% V (L) =0.98 ×TBW; CVV:37.15%. |
|||
Okada 201838 | Japan | Single-center retrospective study | Patients undergoing allo-HSCT who received preventive treatment with vancomycin | NR | 75 | 227 | 49 (range: 17–69) | 49/26 | 59.4 (range: 39.4–104.5) | 113 (range: 47–253) mL/min | Intermittent infusion initial dosage of 1 g/12 hours (if the CLCR was >75 mL/min/1.73 m2). |
Immediately before ad-ministering vancomycin,1 hour after drug administration and at some other points as necessary | Nonlinear mixed-effect modeling approach (NONMEM) | Two-compartment model | Vc (L)= 39.2 × (TBW/59.4)^0.78; CVVc=14.2% CL (L/h) =4.25 × (CLCR/113)^0.70; CVCL=25.2% Vp (L) =56.1; CVVp=66.9% |
|||
Bury 201936 | The Netherlands | Retrospective matched cohort study | Intravenous vancomycin therapy for ≥ 2 days and at least one available vancomycin concentration | 26.7% | 116 | 742 | 61.4 ± 13.4 | 67/49 | NR | Median 92.7 mL/min | Intermittent infusion The specific dosing was not pre-specified |
NR | Nonlinear mixed-effect modeling (NONMEM) | Two-compartment model | CL(L/h) = 3.22+(1+0.00834 × (CLCR −104)) × 1.277NEUTROPENIA; CVCL=33.0% |
Abbreviations: V, volume of distribution; CL, clearance; Ke, elimination rate constant; t1/2, half-life; NR, not reported; ABW, adjusted body weight; TBW, total body weight; CLCR, creatinine clearance; Vc, volume of central compartment; Vss, steady-state volume of distribution; Vp, distribution volume of peripheral compartment.