Vancomycin » Empiric » AUC/MIC

Vancomycin » Empiric therapy » AUC to MIC ratio

simulate_vancomycin_mc_emp_auc_mic_ratio(
  PATID,
  AGE,
  HEIGHT,
  WEIGHT,
  GENDER,
  CREATININE,
  MODEL,
  MIC,
  AUCPERMIC,
  LOADINGDOSE,
  TOXICITYINFO,
  CRCLCAP,
  REGIMENS
)

Arguments

PATID	Patient Identifier. User-provided free text (such as patient id, name or alias) to identify related simulations. Must be provided as string.
AGE	Age. Age of the patient in years. Must be provided as numeric (min. 18, max. 120 year).
HEIGHT	Height. Height of the patient. Must be provided as numeric (min. 100, max. 250 cm).
WEIGHT	Weight. Actual body weight of the patient. Must be provided as numeric (min. 20, max. 500 kg).
GENDER	Sex. Patient's sex for clinical decision-making. Must be provided as string ('Male' or 'Female').
CREATININE	Creatinine. Serum creatinine. Must be provided as numeric (min. 0.01, max. 15 mg/dL).
MODEL	Model for population of interest. Pharmacokinetic model to be used for specific patient type during simulations. Must be provided as string ('Goti et al. (2018) - Patients NOT undergoing hemodialysis', 'Goti et al. (2018) - Patients undergoing hemodialysis', 'Buelga et al. (2005) - Patients with hematological malignancies', 'Buelga et al. (2005) - AML patients, Model 1' or 'Buelga et al. (2005) - AML patients, Model 2').
MIC	MIC. Minimum Inhibitory Concentration (MIC). Must be provided as numeric (min. 0.01, max. 1024 mg/L).
AUCPERMIC	AUC to MIC ratio target. The PK/PD target can be provided as 24 hour area under the concentration-time curve to minimum inhibitory concentration ratio (AUC/MIC). Must be provided as numeric (min. 10, max. 2000 ).
LOADINGDOSE	Loading dose. Loading dose is desired or not. Must be provided as string ('No' or 'Yes').
TOXICITYINFO	Optional information for estimating the probability of nephrotoxicity. This information - if provided - will be used only for estimating the probability of nephrotoxicity. Must be provided as string ('Not applicable', 'General Ward' or 'ICU').
CRCLCAP	Capping Creatinine Clearance. Whether to use capping for creatinine clearance. Must be provided as string ('No cap', '120 ml/min', '130 ml/min', '140 ml/min' or '150 ml/min').
REGIMENS	Dosing Regimens. List of dosing regimens to be used in simulating target attainment, from which the dosing regimen with the smallest absolute difference from the desired target will be automatically selected. Must be provided as list of 1-20 'REGIMEN' values. Use the regimen helper function to define the REGIMEN values.

Details

Drug: Vancomycin

Method: Simulate concentrations for multiple dosing regimens and select the optimal one, with regard to the target pharmacodynamic index.

PK/PD target: 24 hour area under the concentration-time curve to minimum inhibitory concentration ratio.

References

• Goti et al. (2018): Hospitalized Patients With and Without Hemodialysis Have Markedly Different Vancomycin Pharmacokinetics: A Population Pharmacokinetic Model-Based Analysis. In. Therapeutic Drug Monitoring. https://pubmed.ncbi.nlm.nih.gov/29470227/

• Lodise, Thomas P et al. (2009): Relationship between Initial Vancomycin Concentration-Time Profile and Nephrotoxicity among Hospitalized Patients. In. Clinical Infectious Diseases. https://academic.oup.com/cid/article/49/4/507/379286

• Buelga, Dolores Santos et al. (2005): Population Pharmacokinetic Analysis of Vancomycin in Patients with Hematological Malignancies. In. Antimicrobial Agents and Chemotherapy. https://aac.asm.org/content/49/12/4934

• Rybak, Michael J et al. (2020): Therapeutic monitoring of vancomycin for serious methicillin-resistant Staphylococcus aureus infections: A revised consensus guideline and review by the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the Society of Infectious Diseases Pharmacists. In. American Journal of Health-System Pharmacy. https://academic.oup.com/ajhp/article/77/11/835/5810200

Examples

if (FALSE) {
simulate_vancomycin_mc_emp_auc_mic_ratio(PATID = "Anonymous", 
    AGE = 65, HEIGHT = 175, 
    WEIGHT = 75, GENDER = "Male", 
    CREATININE = 1, MODEL = "Goti et al. (2018) - Patients undergoing hemodialysis", 
    MIC = 1, AUCPERMIC = 400, 
    LOADINGDOSE = "No", 
    TOXICITYINFO = "ICU", 
    CRCLCAP = "No cap", 
    REGIMENS = list(list(
        DOSE = 750, INTERVAL = 8, 
        TINF = 1, set = "REGIMEN"), 
        list(DOSE = 750, 
            INTERVAL = 12, 
            TINF = 1, 
            set = "REGIMEN"), 
        list(DOSE = 750, 
            INTERVAL = 24, 
            TINF = 1, 
            set = "REGIMEN"), 
        list(DOSE = 1000, 
            INTERVAL = 8, 
            TINF = 1, 
            set = "REGIMEN"), 
        list(DOSE = 1000, 
            INTERVAL = 12, 
            TINF = 1, 
            set = "REGIMEN"), 
        list(DOSE = 1000, 
            INTERVAL = 24, 
            TINF = 1, 
            set = "REGIMEN"), 
        list(DOSE = 1250, 
            INTERVAL = 8, 
            TINF = 1.25, 
            set = "REGIMEN"), 
        list(DOSE = 1250, 
            INTERVAL = 12, 
            TINF = 1.25, 
            set = "REGIMEN"), 
        list(DOSE = 1250, 
            INTERVAL = 24, 
            TINF = 1.25, 
            set = "REGIMEN"), 
        list(DOSE = 1500, 
            INTERVAL = 8, 
            TINF = 1.5, 
            set = "REGIMEN"), 
        list(DOSE = 1500, 
            INTERVAL = 12, 
            TINF = 1.5, 
            set = "REGIMEN"), 
        list(DOSE = 1500, 
            INTERVAL = 24, 
            TINF = 1.5, 
            set = "REGIMEN"), 
        list(DOSE = 1750, 
            INTERVAL = 8, 
            TINF = 1.75, 
            set = "REGIMEN"), 
        list(DOSE = 1750, 
            INTERVAL = 12, 
            TINF = 1.75, 
            set = "REGIMEN"), 
        list(DOSE = 1750, 
            INTERVAL = 24, 
            TINF = 1.75, 
            set = "REGIMEN")))
}