Population pharmacokinetics and target attainment analysis of vancomycin after intermittent dosing in adults with cystic fibrosis.

Vancomycin is the first-line agent to treat pulmonary infections caused by methicillin-resistant Staphylococcus aureus (MRSA) in people with cystic fibrosis (PwCF). However, there is no consensus on vancomycin initial dosing in this population among health institutions, and there is a large variability in initial dosing across the United States. In this study, we characterized the pharmacokinetics (PK) of vancomycin in PwCF using a population PK approach. The clinical PK data to develop the population PK model were obtained from vancomycin therapeutic monitoring data from PwCF undergoing treatment for infections due to MRSA. The population PK model was then used to perform comprehensive Monte Carlo simulations to evaluate the probability of target attainment (PTA) of 12 different initial dosing scenarios. The area under the curve to minimum inhibitory concentration (MIC) ratio ≥400 mg*h/L and <650 mg*h/L were used as efficacy and toxicity targets for PTA analysis. A total of 181 vancomycin plasma concentrations were included in the analysis. A one-compartment model with first-order elimination best described the data. Weight significantly influenced the vancomycin PK (P < 0.05). In the final model, clearance was estimated as 5.52 L/h/70 kg, and the volume of distribution was 31.5 L/70 kg. The PTA analysis showed that at MIC = 1 µg/mL, doses 1,500 q8h and 2,000 q12h showed the highest %PTA in achieving both efficacy and toxicity targets. The PTA results from this study may potentially inform the initial dosing regimens of vancomycin to treat pulmonary infections due to MRSA in PwCF.

Scholarly Activity of Tenure-Track Faculty in US Departments of Pharmacy Practice.

Objective. To quantitatively determine scholarly activity among tenure-track faculty at US departments of pharmacy practice over a 10-year period.Methods. A search of PubMed was performed for articles by department of pharmacy practice tenure track (DPP-TT) faculty from January 1, 2010, through December 31, 2019. DPP-TT faculty working in departments of pharmacy practice were identified through faculty rosters published on the American Association Colleges of Pharmacy website or college or school internet sites. Tenure-track faculty listed as working in a department of pharmacy practice, clinical pharmacy, or pharmacotherapy were included. An objective third party confirmed the data obtained. Each publication was classified by scope (eg, clinical pharmacology, health economics/outcome research, biomedical informatics, basic science, review, editorial/letter, or case report). DPP-TT faculty productivity was calculated by dataset frequency distribution. Descriptive statistics and analysis of variance were used to compare data across demographic strata.Results. One hundred thirty-seven institutions employed 2147 pharmacy practice faculty. These faculty published 20,059 (9.3±16.3/10 years/faculty member) papers. Six institutions had no tenure-track designation. There was a 2.5-fold increase in publication rates from 2010-2019 (P < 0001). Public vs private schools' productivity was 207.8 vs 69.0 publications per institution, respectively (P < 001). The ratio of male to female DPP-TT faculty per institution was 62% to 38%, with male faculty publishing an average of 12.1±19.1 each, and female faculty publishing an average of 7.4±13.8 each (P < 0001). Faculty ranks were 37% assistant professor; 36% associate professor; and 26% professor, with an average of 4.0±7.3, 8.6±12.4, and 17.4±24.6 publications per faculty, respectively. Regionally, US pharmacy practice faculty located in the West produced the most publications, followed by those in the Northeast, South, and Midwest (P < 0001).Conclusions. These national DPP-TT publication data demonstrate that scholarly productivity increased from 2010 through 2019, across a wide variety of publication scopes.