マルヤマ　タクミ   Maruyama Takumi   丸山　拓実    所属   その他 その他    職種   薬剤師
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Flowchart for predicting achieving the target area under the concentration-time curve of vancomycin in critically ill Japanese patients: A multicenter retrospective study.
掲載誌名	正式名：Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 略　 称：J Infect Chemother ISSNコード：14377780/1341321X
掲載区分	国外
巻・号・頁	pp.10.1016/j.jiac.2023.11.001
著者・共著者	Ishigo Tomoyuki, Fujii Satoshi, Ibe Yuta, Aigami Tomohiro, Nakano Keita, Fukudo Masahide, Yoshida Hiroaki, Tanaka Hiroaki, Ebihara Fumiya, Maruyama Takumi, Hamada Yukihiro, Suzuki Ayako, Fujihara Hisato, Yamaguchi Fumihiro, Samura Masaru, Nagumo Fumio, Komatsu Toshiaki, Tomizawa Atsushi, Takuma Akitoshi, Chiba Hiroaki, Nishi Yoshifumi, Enoki Yuki, Taguchi Kazuaki, Matsumoto Kazuaki
発行年月	2023/11
概要	INTRODUCTION:In therapeutic drug monitoring (TDM) of vancomycin (VCM), the area under the concentration-time curve (AUC) is related to the clinical efficacy and toxicity. Therefore, herein, we examined the factors associated with achieving the target AUC at follow-up and developed a decision flowchart for achieving the target AUC in critically ill patients.METHODS:This multicenter retrospective observational study was conducted at eight hospitals. We retrospectively analyzed data from patients who had received VCM in the intensive care unit from January 2020 to December 2022. Decision-tree (DT) analysis was performed using factors with p < 0.1 in univariate analysis as the independent variables. Case data were split up to two times, and four subgroups were included. The primary endpoint was achieving the target AUC at the follow-up TDM (AUCfollow-up) and target AUCfollow-up achievement was defined as an AUC of 400-600 μg‧h/mL. The initial AUC values were calculated with the 2-point concentrations (peak and trough) using the Bayesian estimation software Practical AUC-guided TDM (PAT).RESULTS:Among 70 patients (median age [interquartile range], 66 [56, 79] years; 50 % women), the AUCfollow-up was achieved in 70 % (49/70). Three factors were selected for the decision flow chart: predicted AUCfollow-up of 400-600 μg‧h/mL, dosing at 12-hour intervals, and CCr of 130 mL/min/1.73 m2 or higher; the accuracy was adequate (92 %, R2 = 0.52).CONCLUSION:We successfully identified the factors associated with achieving the target AUC of VCM at follow-up TDM and developed a simple-to-use DT model. However, the validity of the findings needs to be evaluated.
DOI	10.1016/j.jiac.2023.11.001
PMID	37925103