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Open AccessArticle

Application of Pharmacometrics in Pharmacotherapy: Open-Source Software for Vancomycin Therapeutic Drug Management

1
PIPET (Pharmacometrics Institute for Practical Education and Training), College of Medicine, The Catholic University of Korea, 222 Banpodaero Seocho-gu, Seoul 06591, Korea
2
Department of Pharmacology, College of Medicine, The Catholic University of Korea, 222 Banpodaero, Seocho-gu, Seoul 06591, Korea
3
Department of Pharmacy, Seoul St. Mary’s Hospital, The Catholic University of Korea, 222 Banpodaero Seocho-gu, Seoul 06591, Korea
*
Author to whom correspondence should be addressed.
Pharmaceutics 2019, 11(5), 224; https://doi.org/10.3390/pharmaceutics11050224
Received: 18 February 2019 / Revised: 31 March 2019 / Accepted: 30 April 2019 / Published: 9 May 2019
The population pharmacokinetic (PK) parameters that are implemented in therapeutic drug management (TDM) software were generally obtained from a Western population and might not be adequate for PK prediction with a Korean population. This study aimed to develop a population PK model for vancomycin using Korean data to improve the quality of TDM for Korean patients. A total of 220 patients (1020 observations) who received vancomycin TDM services were included in the dataset. A population PK analysis was performed using non-linear mixed effects modeling, and a covariate evaluation was conducted. A two-compartment model with first-order elimination best explained the vancomycin PK, with estimates of 2.82 L/h, 31.8 L, 11.7 L/h, and 75.4 L for CL, V1, Q, and V2, respectively. In the covariate analysis, weight correlated with the volume of the peripheral compartment, and creatinine clearance, hemodialysis, and continuous renal replacement therapy treatments contributed to the clearance of vancomycin. The results show the clear need to optimize the PK parameters used for TDM in Korean patients. Specifically, V1 should be smaller for Korean patients, and renal replacement therapies should be considered in TDM practice. This final model was successfully applied in R shiny as open-source software for Koreans. View Full-Text
Keywords: Korean; vancomycin; therapeutic drug management; population pharmacokinetics; open-source software Korean; vancomycin; therapeutic drug management; population pharmacokinetics; open-source software
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Bae, S.H.; Yim, D.-S.; Lee, H.; Park, A.-R.; Kwon, J.-E.; Sumiko, H.; Han, S. Application of Pharmacometrics in Pharmacotherapy: Open-Source Software for Vancomycin Therapeutic Drug Management. Pharmaceutics 2019, 11, 224.

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