ABSTRACT
Objective To investigate the clinical efficiency of serum cystatin C as a marker of renal function to predict serum trough concentrations of vancomycin. Methods Data on trough concentrations of vancomycin(Cmea ),serum creatinine (Scr)concentrations,cystatin C( Cys C) concentrations were collected from 81 hospitalized patients who received vancomycin therapy. Predicted vancomycin trough concentrations(Cpre )were calculated based on Scr or Cys C concentrations associating with Bayesian forecasting method through NONMEM software. Finally,the correlations and distinctions between Cpre and Cmea were comparatively analyzed. Results There were both correlation between Cpre and Cmea in relation to Scr or Cys C(r = 0. 678,P<0. 01;r=0. 727,P<0. 01). Besides,the errors of mean predictive error(ME),mean absolute error(MAE)and root-mean-square error(RMSE)for Scr was - 5. 79,6. 86,9. 86 μg · mL-1 , respectively, where as the errors for Cys C was - 0. 82,5. 42, 7. 74 μg·mL-1 ,respectively. Conclusion Cystatin C is a good marker of renal function available for predicting serum vancomycin concentrations.
ABSTRACT
Combining the classic pharmacokinetic principles and statistical methods ,population pharmacokinetics (PPK ) can predict individual pharmacokinetic parameters accurately with sparse data in patients ,which may be used for monitoring drug concentration in patients and realizing individual dose regimen .In this article ,we review the recent application of PPK in drugs with narrow therapeutic windows or great individual differences ,combining medication ,medication in special populations and so on ,providing useful information for further investigation of PPK and its application in clinical medication .