Validation of vancomycin population pharmacokinetic model for pediatric patients / 中国药学杂志

ABSTRACT

OBJECTIVE: To choose a PPK model of vancomycin most suitable for Chinese pediatric patients, in order to guide the dosage adjustment. METHODS: Based on the database of PubMed and CNKI, all studies regarding vancomycin population pharmacokinetics were investigated and their basic information including PPK models was extracted. The data of Chinese pediatric patients who were administered vancomycin and received therapeutic drug monitoring (TDM) were introduced into the reported final PPK models, and the fitting was conducted by model fitting graphics. RESULTS: Twelve vancomycin PPK studies during 1986-2014 were included. As judged by the correlation coefficient (R) and R-square (R2) between predicted concentration and measured concentration, the models 4 and 9 presented a relatively better fitting with the data of Chinese pediatric patients we collected. The VPC fitting demonstrated that number 1 model achieved the best fitting. However, because the limited data used in this study was based on irregular sampling time, so the VPC test results were difficult to be distinguished and could only be used as a secondary reference. On the other hand, NPDE has corresponding statistical test, and its evaluation ability for the model is not affected by the factors of the experimental design. NPDE analysis showed that one-compartment model was better than two-compartment model, and model 4 and model 9 achieved better fitting to the collected data than others. CONCLUSION: The fitting effects of most reported vancomycin PPK models, except individual models, were poor for the TDM data of Chinese pediatric patients, therefore it is necessary to establish a vancomycin population pharmacokinetic model particularity for Chinese pediatric patients, in order to guide dosage adjustment more accurately.