Identification of Patients Who Require Two-Point Blood Sampling for the Peak and Trough Values Rather Than One-Point Blood Sampling for the Trough Value for the Evaluation of AUC of Vancomycin Using Bayesian Estimation

Ayako Suzuki¹, Masaru Samura^{2

3}, Tomoyuki Ishigo⁴, Satoshi Fujii⁴, Yuta Ibe⁴, Hiroaki Yoshida⁵, Hiroaki Tanaka⁵, Fumiya Ebihara⁶, Takumi Maruyama⁶, Yukihiro Hamada^{6

7}, Hisato Fujihara^{1

8}, Fumihiro Yamaguchi⁹, Fumio Nagumo¹⁰, Toshiaki Komatsu¹¹, Atsushi Tomizawa¹¹, Akitoshi Takuma^{8

12}, Hiroaki Chiba¹³, Yoshifumi Nishi¹⁴, Yuki Enoki¹⁵, Kazuaki Taguchi¹⁵, Kazuaki Matsumoto¹⁵

Affiliations

¹ Department of Pharmacy, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-Ku, Yokohama-Shi, Kanagawa, 227-8501, Japan.
² Division of Pharmacodynamics, Faculty of Pharmacy, Keio University, 1-5-30 Shibakoen, Minato-Ku, Tokyo, 105-8512, Japan. masaru.samura@gmail.com.
³ Department of Pharmacy, Yokohama General Hospital, 2201-5 Kuroganecho, Aoba-Ku, Yokohama-Shi, Kanagawa, 225-0025, Japan. masaru.samura@gmail.com.
⁴ Department of Pharmacy, Sapporo Medical University Hospital, 291 Nishi 16-Chome, Minami 1-Jo, Chuo-Ku, Sapporo-Shi, Hokkaido, 060-8543, Japan.
⁵ Department of Pharmacy, Kyorin University Hospital, 6-20-2 Shinkawa, Mitaka-Shi, Tokyo, 181-8611, Japan.
⁶ Department of Pharmacy, Tokyo Women's Medical University Hospital, 8-1 Kawada-Cho, Shinjuku-Ku, Tokyo, 162-8666, Japan.
⁷ Department of Pharmacy, Kochi Medical School Hospital, 185-1 Okochokohasu, Nankoku-Shi, Kochi, 783-8505, Japan.
⁸ Department of Hospital Pharmaceutics, School of Pharmacy, Showa University, 1-5-8 Hatanodai, Shinagawa-Ku, Tokyo, 142-8555, Japan.
⁹ Department of Respiratory Medicine, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-Ku, Yokohama-Shi, Kanagawa, 227-8501, Japan.
¹⁰ Department of Pharmacy, Yokohama General Hospital, 2201-5 Kuroganecho, Aoba-Ku, Yokohama-Shi, Kanagawa, 225-0025, Japan.
¹¹ Department of Pharmacy, Kitasato University Hospital, 1-15-1 Kitasato, Minami-Ku, Sagamihara-Shi, Kanagawa, 252-0375, Japan.
¹² Department of Pharmacy, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-Chuo, Tsuzuki-Ku, Yokohama-Shi, Kanagawa, 224-0032, Japan.
¹³ Department of Pharmacy, Tohoku Kosai Hospital, 2-3-11 Kokubuncho, Aoba-Ku, Sendai-Shi, Miyagi, 980-0803, Japan.
¹⁴ Center for Pharmacist Education, School of Pharmacy, Nihon University, 7-7-1 Narashinodai, Funabashi-Shi, Chiba, 274-0063, Japan.
¹⁵ Division of Pharmacodynamics, Faculty of Pharmacy, Keio University, 1-5-30 Shibakoen, Minato-Ku, Tokyo, 105-8512, Japan.

PMID: 39433691
DOI: 10.1007/s11095-024-03781-4

Identification of Patients Who Require Two-Point Blood Sampling for the Peak and Trough Values Rather Than One-Point Blood Sampling for the Trough Value for the Evaluation of AUC of Vancomycin Using Bayesian Estimation

Ayako Suzuki et al. Pharm Res. 2024 Nov.

. 2024 Nov;41(11):2161-2171.

doi: 10.1007/s11095-024-03781-4. Epub 2024 Oct 21.

Authors

Affiliations

¹ Department of Pharmacy, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-Ku, Yokohama-Shi, Kanagawa, 227-8501, Japan.
² Division of Pharmacodynamics, Faculty of Pharmacy, Keio University, 1-5-30 Shibakoen, Minato-Ku, Tokyo, 105-8512, Japan. masaru.samura@gmail.com.
³ Department of Pharmacy, Yokohama General Hospital, 2201-5 Kuroganecho, Aoba-Ku, Yokohama-Shi, Kanagawa, 225-0025, Japan. masaru.samura@gmail.com.
⁴ Department of Pharmacy, Sapporo Medical University Hospital, 291 Nishi 16-Chome, Minami 1-Jo, Chuo-Ku, Sapporo-Shi, Hokkaido, 060-8543, Japan.
⁵ Department of Pharmacy, Kyorin University Hospital, 6-20-2 Shinkawa, Mitaka-Shi, Tokyo, 181-8611, Japan.
⁶ Department of Pharmacy, Tokyo Women's Medical University Hospital, 8-1 Kawada-Cho, Shinjuku-Ku, Tokyo, 162-8666, Japan.
⁷ Department of Pharmacy, Kochi Medical School Hospital, 185-1 Okochokohasu, Nankoku-Shi, Kochi, 783-8505, Japan.
⁸ Department of Hospital Pharmaceutics, School of Pharmacy, Showa University, 1-5-8 Hatanodai, Shinagawa-Ku, Tokyo, 142-8555, Japan.
⁹ Department of Respiratory Medicine, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-Ku, Yokohama-Shi, Kanagawa, 227-8501, Japan.
¹⁰ Department of Pharmacy, Yokohama General Hospital, 2201-5 Kuroganecho, Aoba-Ku, Yokohama-Shi, Kanagawa, 225-0025, Japan.
¹¹ Department of Pharmacy, Kitasato University Hospital, 1-15-1 Kitasato, Minami-Ku, Sagamihara-Shi, Kanagawa, 252-0375, Japan.
¹² Department of Pharmacy, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-Chuo, Tsuzuki-Ku, Yokohama-Shi, Kanagawa, 224-0032, Japan.
¹³ Department of Pharmacy, Tohoku Kosai Hospital, 2-3-11 Kokubuncho, Aoba-Ku, Sendai-Shi, Miyagi, 980-0803, Japan.
¹⁴ Center for Pharmacist Education, School of Pharmacy, Nihon University, 7-7-1 Narashinodai, Funabashi-Shi, Chiba, 274-0063, Japan.
¹⁵ Division of Pharmacodynamics, Faculty of Pharmacy, Keio University, 1-5-30 Shibakoen, Minato-Ku, Tokyo, 105-8512, Japan.

PMID: 39433691
DOI: 10.1007/s11095-024-03781-4

Abstract

Objectives: It is recommended to adjust the dose of vancomycin (VCM) with a target area under the concentration-time curve (AUC) of 400-600 μg·h/mL. Factors that affect the deviation between AUCs are estimated from the trough value alone and the trough and peak values using practical AUC-guided therapeutic drug monitoring (PAT) for vancomycin. In this study, factors that affect AUC were evaluated.

Methods: AUCs were estimated from a single trough value and trough and peak values, and the patients were classified into those who showed a 10% or greater deviation (deviation group) and those in whom the deviation was less than 10% (no-deviation group). Risk factors related to ≥ 10% deviation of AUC were identified by univariate and multivariate analysis.

Results: As a result of univariate and multivariate analysis of 30 patients in the deviation group and 344 patients in the no-deviation group, a creatinine clearance (CLcr) of ≥ 110 mL/min (odds ratio (OR) = 3.697, 95% confidence interval (CI) = 1.616-8.457, p = 0.002), heart failure with a brain natriuretic peptide (BNP) of ≥ 300 pg/mL (OR = 4.854, 95%CI = 1.199-19.656, p = 0.027), and the concomitant use of angiotensin converting enzyme inhibitor or angiotensin II receptor blocker (ACE-I/ARB) (OR = 2.544, 95%CI = 1.074-6.024, p = 0.034) were identified as risk factors of ≥ 10% deviation of AUC.

Conclusions: Estimation of AUC by two-point blood sampling for the trough and peak values rather than one-point blood sampling for the trough value is suggested to improve the prediction accuracy in patients with enhanced renal function, severe heart failure, and patients using ACE-I/ARB.

Keywords: area under the concentration–time curve; one-point sampling; two-point sampling; vancomycin.

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Conflict of interest statement

Declarations. Conflict of Interest: KM received grant support funding from Meiji Seika Pharma Co., Ltd., Sumitomo Pharma Co., Ltd., and Shionogi & Co., Ltd., and speaker honoraria from Meiji Seika Pharma Co., Ltd. The other authors have no conflicts of interest to declare.

References

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Identification of Patients Who Require Two-Point Blood Sampling for the Peak and Trough Values Rather Than One-Point Blood Sampling for the Trough Value for the Evaluation of AUC of Vancomycin Using Bayesian Estimation

Affiliations

Identification of Patients Who Require Two-Point Blood Sampling for the Peak and Trough Values Rather Than One-Point Blood Sampling for the Trough Value for the Evaluation of AUC of Vancomycin Using Bayesian Estimation

Authors

Affiliations

Abstract

Conflict of interest statement

References

MeSH terms

Substances

LinkOut - more resources

Full Text Sources

Medical

Research Materials

Miscellaneous