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Performance of Area under the Concentration-Time Curve Estimations of Vancomycin with Limited Sampling by a Newly Developed Web Application

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Abstract

Purpose

Therapeutic drug monitoring guided by the area under the concentration-time curve (AUC-guided TDM) is recommended for vancomycin. However, validated efficient software remains elusive to popularize AUC-guided TDM in Japan. The aim of this study was to validate a newly developed web application, PAT, for AUC estimation.

Methods

PAT was developed on the R ver. 3.6.2 platform for use with mobile phones and personal computers. AUC estimated by PAT (AUCPAT) was evaluated against the reference AUC (AUCREF) calculated with the log-linear trapezoidal rule using eight measured concentrations, or against AUC (AUCBM-P) calculated using an evaluated available software with clinical data.

Results

Investigating the best sampling points with limited sampling, PAT produced the least bias using two concentrations at 1 h and 11 h after the end of infusion (slope 1.18, intercept −15.57, median AUCPAT/AUCREF 0.93 [range 0.81–1.24]), where only one estimation (6%) was out of the predetermined acceptable range of 0.8–1.2. Employment of only a trough concentration was more biased (AUCPAT/AUCREF range 0.73–1.30 for 11 h, AUCPAT/AUCREF range 0.62–1.40 for 23 h). In comparison with the evaluated software, AUCPAT was not biased against the AUCBM-P (slope 1.04, intercept −15.80, median AUCPAT/AUCBM-P 1.00 [range 0.86–1.10]).

Conclusions

The new application using two concentrations was appropriately validated and might be efficient in popularizing the AUC-guided TDM of vancomycin.

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Abbreviations

AUC :

Area under the concentration-time curve

AUC PAT :

AUC estimated by PAT

AUC REF :

Reference AUC

MIC :

Minimum inhibitory concentration

PAT :

Practical AUC-guided therapeutic drug monitoring

PK :

Pharmacokinetics

popPK :

Population pharmacokinetics

TDM :

Therapeutic drug monitoring

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Authors and Affiliations

  1. Department of Pharmacy, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556, Japan

    Kazutaka Oda, Yumi Hashiguchi & Hideyuki Saito

  2. Department of Infection Control, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556, Japan

    Kazutaka Oda

  3. Department of Pharmacy, Tokyo Women’s Medical University Hospital, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan

    Toshimi Kimura

  4. Center for Pharmacist Education, School of Pharmacy, Nihon University, 7-7-1, Narashinodai, Funabashi-shi, Chiba, 274-8555, Japan

    Yasuhiro Tsuji

  5. Division of Infectious Diseases, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 157-8535, Japan

    Kensuke Shoji

  6. Department of Pharmacy, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya-shi, Hyogo, 663-8501, Japan

    Yoshiko Takahashi

  7. Division of Pharmacodynamics, Keio University Faculty of Pharmacy, 1-5-30, Shibakoen, Minato-ku, Tokyo, 105-8512, Japan

    Kazuaki Matsumoto

  8. Department of Infection Control and Prevention, Kagoshima University Hospital, 8-35-1, Sakuragaoka, Kagoshima-shi, Kagoshima, 890-8520, Japan

    Hideki Kawamura

  9. Department of Infection Control and Prevention, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya-shi, Hyogo, 663-8501, Japan

    Yoshio Takesue

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  1. Kazutaka Oda
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  2. Yumi Hashiguchi
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Correspondence to Kazutaka Oda.

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Oda, K., Hashiguchi, Y., Kimura, T. et al. Performance of Area under the Concentration-Time Curve Estimations of Vancomycin with Limited Sampling by a Newly Developed Web Application. Pharm Res 38, 637–646 (2021). https://doi.org/10.1007/s11095-021-03030-y

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