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Maruyama Takumi
Department Other, Other Position |
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| Article types | Original article |
| Language | English |
| Peer review | Peer reviewed |
| Title | Flowchart for predicting achieving the target area under the concentration-time curve of vancomycin in critically ill Japanese patients: A multicenter retrospective study. |
| Journal | Formal name：Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy Abbreviation：J Infect Chemother ISSN code：14377780/1341321X |
| Domestic / Foregin | Foregin |
| Volume, Issue, Page | pp.10.1016/j.jiac.2023.11.001 |
| Author and coauthor | 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 |
| Publication date | 2023/11 |
| Summary | 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 |