Composition and Clinical Application of A Program of Model-Informed Individualized Administration of Vancomycin in Children
OBJECTIVE To promote individualized mediaction of vancomycin in pediatric patients by model-informed precision do-sing.METHODS The data of vancomycin serum concentration were collected,and the population pharmacokinetics model,which is suitable for Chinese children,was selected through literature search and external validation.The optimal model was embedded into the user-defined module of JPKD software,and a prediction program of individualized medication was established based on maximum a poste-riori-Bayesian.This program was applied to individualized dose adjustment for pediatric patients.Case-based clinical practice was used to evaluate the application of this program.RESULTS A total of 32 vancomycin concentration data collected from 22 children with a medi-an age of 6.04 years(44 weeks to 14.58 years)were used for external validation.Comparing the predicted concentration with the meas-ured concentration,the mean prediction error,mean absolute prediction error and mean squared prediction error were(0.098 4±0.141)(0.109±0.133)mg·L-1 and(0.029 0±0.087 2)mg2·L-2,respectively.The results of external validation showed that the selected model had an acceptable predictive performance and was appropriate for the target group in this study.Dosing regimens of vancomycin were adjusted for four pediatric patients based on the predicted results of individualized adjuvant medication program,which led to an ef-fectively improved target attainment situation of vancomycin trough concentration and AUC24h,significantly convalescent clinical symptoms and inflammatory indicators,while no adverse reactions occurred.CONCLUSION In the current study,a prediction program for indi-vidualized medication of vancomycin is successfully established by independent programming and applied to clinical cases.It guarantees the effectiveness and safety of anti-infective therapy for patients.
万方数据
维普
