新生児におけるバンコマイシン母集団薬物動態モデル13種の比較検討

Vancomycin is recommended for the treatment of Methicillin-Resistant Staphylococcus aureus (MRSA) in neonates. Because vancomycin has potential to produce adverse drug reactions such as nephrotoxicity, therapeutic drug monitoring is required to optimize treatment. Therefore, this study aimed to evaluate the predictive performance of published population pharmacokinetic (PPK) models of vancomycin in neonates. Demographic and laboratory data were retrospectively collected from medical records of 54 neonatal patients who underwent vancomycin treatment. We evaluate the predictability of vancomycin concentrations by using typical pharmacokinetic parameters in pre-existing 13 PPK models. The predictive performance from two PPK models was better than that from the other PPK studies (r = 0.806, prediction error (ME) -3.24 mg/L, mean absolute prediction error (MAE) 4.58 mg/L for model of Bhongsatiern et al; r = 0.803, ME -3.48 mg/L, MAE 4.73 mg/L for model of Mehrotra et al). Finally, we constructed a suggested initial dose schedule of vancomycin. Our findings provide useful information for adjusting vancomycin dosage to improve clinical safety and effectiveness.