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Drug design, development and therapy
2024;18 6185-6198.

Factors Affecting Vancomycin Trough Concentration; a Population Pharmacokinetic Model in Non-Critical Care Saudi Patients.

Aymen Ali Alqurain, Laila Nasser Alrashidi, Shatha Khalid Aloraifej, Moayd Alkhalifah, Hawra Ali Alsayed, Salah Abohelaika, Mohammad A Alshabeeb, Amal Shibak Aldhafeeri, Moyad Almuslim, Thuraya Nasser Bumozah, Mukhtar Jawad Alomar, Azhar Abdullah Alshehab, Ahmed AbdulWahab Alamer, Jenan Al-Matouq, Keshore R Bidasee, Fadhel A Alomar
Author Information
  1. Aymen Ali Alqurain: Department of Clinical Practice, College of Pharmacy, Northern Border University, Rafha, 91911, Saudi Arabia. ORCID
  2. Laila Nasser Alrashidi: Department of Pharmacy, Mohammed Al-Mana College for Medical Sciences, Dammam, 34222, Saudi Arabia.
  3. Shatha Khalid Aloraifej: Department of Pharmacy, Mohammed Al-Mana College for Medical Sciences, Dammam, 34222, Saudi Arabia.
  4. Moayd Alkhalifah: Department of Neurology, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia.
  5. Hawra Ali Alsayed: Department of Pharmacy, Rashid Hospital, Dubai Academic Health Corporation, Dubai, United Arab Emirates.
  6. Salah Abohelaika: Research Department, Qatif Central Hospital, Qatif, 32654, Saudi Arabia.
  7. Mohammad A Alshabeeb: Pharmaceutical Analysis Center, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
  8. Amal Shibak Aldhafeeri: Pharmacy Department, Al Mana General Hospitals, Al-Khobar, Saudi Arabia. ORCID
  9. Moyad Almuslim: Department of Pharmacology, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, 31441, Saudi Arabia. ORCID
  10. Thuraya Nasser Bumozah: Pharmacy Department, Maternity and Children Hospital in Huffuf, Al Hufuf, Saudi Arabia. ORCID
  11. Mukhtar Jawad Alomar: Pharmaceutical Affair, Dammam Medical Complex, Eastern Health Cluster, Dammam, Saudi Arabia.
  12. Azhar Abdullah Alshehab: Medical Supply Department, Prince Saud Bin Jalawy Hospital, Mubarraz, Saudi Arabia.
  13. Ahmed AbdulWahab Alamer: Pharmaceutical Care Department, King Abdulaziz Hospital in Alahssa, Ministry of National Guard, Mubarraz, Saudi Arabia.
  14. Jenan Al-Matouq: Department of Medical Laboratory Science, Mohammed Al-Mana College for Medical Sciences, Al Safa, Dammam, 34222, Saudi Arabia. ORCID
  15. Keshore R Bidasee: Department of Pharmacology and Experiment Neuroscience, University of Nebraska Medical Center, Omaha, NE, 68198, USA.
  16. Fadhel A Alomar: Department of Pharmacology, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, 31441, Saudi Arabia. ORCID
PMID: 39722680 DOI: 10.2147/DDDT.S496512

Abstract

Background and Objective: Vancomycin is commonly prescribed in treatment of methicillin-resistant Staphylococcus aureus infections. While, vancomycins' pharmacokinetic vary among older patients, there is a paucity of data regarding specific characteristics influencing pharmacokinetics in Saudi adult patients. This study aims to establish a population-pharmacokinetic (Pop-PK) model for vancomycin in patients admitted to medical wards, with the focus on identification of patient characteristics influencing vancomycin trough concentrations.
Methods: A multicenter retrospective study was conducted involving patients aged ≥40 years admitted to medical wards in the Eastern Province, Saudi Arabia and initiated on vancomycin, between January to December 2022. Non-linear mixed-effects modelling (Monolix) was employed to develop the Pop-PK model. A base model was selected based on the Akaike information criterion. Covariates considered included age, sex, body weight, C-reactive protein (CRP), serum creatinine, creatinine clearance (CrCl), and albumin levels. A -value of <0.05 was considered statistically significant for inclusion of covariates in the final model by stepwise addition. The simulation performance of the model was assessed by visual predictive check plot. The final model was simulated using Simulx software to assess the effect of the included covariates on vancomycin trough concentration.
Results: A total of 172 vancomycin trough concentrations from 124 patients were analyzed. The final Pop-PK model characterized vancomycin trough concentrations was one compartment distribution with linear elimination. CrCl and CRP were the only covariates included in the final model, as they reduced the between-subject variability (BSV) for clearance (from 173% to 81%). The simulated model demonstrated that high CRP value and low CrCl contributed to increased vancomycin trough concentrations.
Conclusion: This study highlights large BSV in trough concentrations among patients and emphasizes the influencing of CrCl and CRP on vancomycin pharmacokinetics in medical care settings.

Keywords

C-reactive protein creatinine clearance medical care patients population pharmacokinetics vancomycin trough concentration

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MeSH Term

Humans
Vancomycin
Saudi Arabia
Male
Female
Middle Aged
Retrospective Studies
Anti-Bacterial Agents
Aged
Adult
Models, Biological
Methicillin-Resistant Staphylococcus aureus

Chemicals

Vancomycin
Anti-Bacterial Agents
Journal Article Multicenter Study

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