Implementing Vancomycin Population Pharmacokinetic Models: An App for Individualized Antibiotic Therapy in Critically Ill Patients

13 páginas

Autores:

Tipo de recurso:

Fecha de publicación:: 2023

Institución:: Universidad de la Sabana

Repositorio:: Repositorio Universidad de la Sabana

Idioma:: eng

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network_name_str	Repositorio Universidad de la Sabana
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spelling	Implementing Vancomycin Population Pharmacokinetic Models: An App for Individualized Antibiotic Therapy in Critically Ill PatientsVancomycinBayesian predictionPopulation pharmacokineticsPersonalized dosingIndividualized therapyCritical ill patientsTherapeutic drug managementShiny application13 páginasIn individualized therapy, the Bayesian approach integrated with population pharmacokinetic models (PopPK) for predictions together with therapeutic drug monitoring (TDM) to maintain adequate objectives is useful to maximize the efficacy and minimize the probability of toxicity of vancomycin in critically ill patients. Although there are limitations to implementation, model-informed precision dosing (MIPD) is an approach to integrate these elements, which has the potential to optimize the TDM process and maximize the success of antibacterial therapy. The objective of this work was to present an app for individualized therapy and perform a validation of the implemented vancomycin PopPK models. A pragmatic approach was used for selecting the models of Llopis, Goti and Revilla for developing a Shiny app with R. Through ordinary differential equation (ODE)-based mixed effects models from the mlxR package, the app simulates the concentrations¿ behavior, estimates whether the model was simulated without variability and predicts whether the model was simulated with variability. Moreover, we evaluated the predictive performance with retrospective trough concentration data from patients admitted to the adult critical care unit. Although there were no significant differences in the performance of the estimates, the Llopis model showed better accuracy (mean 80.88%; SD 46.5%); however, it had greater bias (mean ¿34.47%, SD 63.38%) compared to the Revilla et al. (mean 10.61%, SD 66.37%) and Goti et al. (mean of 13.54%, SD 64.93%) models. With respect to the RMSE (root mean square error), the Llopis (mean of 10.69 mg/L, SD 12.23 mg/L) and Revilla models (mean of 10.65 mg/L, SD 12.81 mg/L) were comparable, and the lowest RMSE was found in the Goti model (mean 9.06 mg/L, SD 9 mg/L). Regarding the predictions, this behavior did not change, and the results varied relatively little. Although our results are satisfactory, the predictive performance in recent studies with vancomycin is heterogeneous, and although these three models have proven to be useful for clinical application, further research and adaptation of PopPK models is required, as well as implementation in the clinical practice of MIPD and TDM in real time.Universidad de La Sabana2024-01-12T13:17:10Z2024-01-12T13:17:10Z2023-08-09Tesis/Trabajo de grado - Especializaciónhttp://purl.org/coar/resource_type/c_7a1fTextoinfo:eu-repo/semantics/otherhttp://purl.org/redcol/resource_type/COtherinfo:eu-repo/semantics/acceptedVersionapplication/pdfapplication/pdfhttps://hdl.handle.net/10818/5903610.3390/antibiotics12020301engAttribution-NonCommercial-NoDerivatives 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/http://purl.org/coar/access_right/c_abf2Mena, ManuelGarcia, Julio CesarBustos, Rosa Helenaoai:intellectum.unisabana.edu.co:10818/590362025-12-11T18:16:46Z
dc.title.none.fl_str_mv	Implementing Vancomycin Population Pharmacokinetic Models: An App for Individualized Antibiotic Therapy in Critically Ill Patients
title	Implementing Vancomycin Population Pharmacokinetic Models: An App for Individualized Antibiotic Therapy in Critically Ill Patients
spellingShingle	Implementing Vancomycin Population Pharmacokinetic Models: An App for Individualized Antibiotic Therapy in Critically Ill Patients Vancomycin Bayesian prediction Population pharmacokinetics Personalized dosing Individualized therapy Critical ill patients Therapeutic drug management Shiny application
title_short	Implementing Vancomycin Population Pharmacokinetic Models: An App for Individualized Antibiotic Therapy in Critically Ill Patients
title_full	Implementing Vancomycin Population Pharmacokinetic Models: An App for Individualized Antibiotic Therapy in Critically Ill Patients
title_fullStr	Implementing Vancomycin Population Pharmacokinetic Models: An App for Individualized Antibiotic Therapy in Critically Ill Patients
title_full_unstemmed	Implementing Vancomycin Population Pharmacokinetic Models: An App for Individualized Antibiotic Therapy in Critically Ill Patients
title_sort	Implementing Vancomycin Population Pharmacokinetic Models: An App for Individualized Antibiotic Therapy in Critically Ill Patients
dc.subject.none.fl_str_mv	Vancomycin Bayesian prediction Population pharmacokinetics Personalized dosing Individualized therapy Critical ill patients Therapeutic drug management Shiny application
topic	Vancomycin Bayesian prediction Population pharmacokinetics Personalized dosing Individualized therapy Critical ill patients Therapeutic drug management Shiny application
description	13 páginas
publishDate	2023
dc.date.none.fl_str_mv	2023-08-09 2024-01-12T13:17:10Z 2024-01-12T13:17:10Z
dc.type.none.fl_str_mv	Tesis/Trabajo de grado - Especialización http://purl.org/coar/resource_type/c_7a1f Texto info:eu-repo/semantics/other http://purl.org/redcol/resource_type/COther info:eu-repo/semantics/acceptedVersion
status_str	acceptedVersion
dc.identifier.none.fl_str_mv	https://hdl.handle.net/10818/59036 10.3390/antibiotics12020301
url	https://hdl.handle.net/10818/59036
identifier_str_mv	10.3390/antibiotics12020301
dc.language.none.fl_str_mv	eng
language	eng
dc.rights.none.fl_str_mv	Attribution-NonCommercial-NoDerivatives 4.0 Internacional http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.coar.fl_str_mv	http://purl.org/coar/access_right/c_abf2
rights_invalid_str_mv	Attribution-NonCommercial-NoDerivatives 4.0 Internacional http://creativecommons.org/licenses/by-nc-nd/4.0/ http://purl.org/coar/access_right/c_abf2
dc.format.none.fl_str_mv	application/pdf application/pdf
dc.publisher.none.fl_str_mv	Universidad de La Sabana
publisher.none.fl_str_mv	Universidad de La Sabana
institution	Universidad de la Sabana
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_	1860892063890931712

Implementing Vancomycin Population Pharmacokinetic Models: An App for Individualized Antibiotic Therapy in Critically Ill Patients

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