Performance of Various Pharmacokinetic Parameters in Predicting Vancomycin Serum Concentrations

The pharmacokinetic parameters of vancomycin have been much reported on.In order to plan initial dosage regimens precisely,we retrospectively investigated the predictive performance of pharmacokinetic parameters reported by Winter,Matzke,Grasela,Ducharme,Rodvold and Yasuhara and parameters for Japanese included in TDM analysis support software (Japanese parameters).We also investigated the propriety of amending serum creatinine concentrations (Scr).Amending Scr based on the Japanese parameters from under 0.6 mg/dL to 0.6 mg/dL gave the best predictive performance for patients overall.Regarding sex and age,amendment based on Matzke’s parameters for male patients under 65 produced good predictive performance and Yasuhara’s parameters achieved good predictive performance for male patients over 65.Amendment based on Rodvold’s parameters for female patients under 65 and that based on the Japanese parameters for female patients above 65 gave good predictive performance.Thus in the initial dosage regimen,VCM parameters that gave good predictive performance differed by age and sex and Scr.We also showed that it was useful to amend Scrs of under 0.6 mg/dL to 0.6 mg/dL in the revision.It is therefore possible to precisely plan initial dosage regimens using VCM parameters that are suitable for each patient.