Zhang et al. 2024

How to Dose Vancomycin in Overweight and Obese Patients with Varying Renal (Dys)function in the Novel Era of AUC 400-600 mg-h/L-Targeted Dosing

Clinical Pharmacokinetics · 10.1007/s40262-023-01324-5

Structure

A three-compartment model, driven by creatinine clearance, weight and critically ill.

Study population

Obese and Critically ill patients — Netherlands and Europe. Fitted to 230 patients and 1,395 concentration observations.

Covariate As reported
Age 70 (23–92) yr
Weight 91.8 (58.6–234.6) kg
BMI 30 (25–65.7) kg/m²
CrCl 74.5 (6–154.9) mL/min
SCr 0.95 (0.26–8.46) mg/dL

Reported as the source publication gives them — mean ± SD, or median with range or interquartile range.

Equations

The model's structural parameters as Chorus implements them.

CL=3.36(eGFR75)0.658[1+0.0106(TBW90)]FICUCL = 3.36 \cdot \left(\frac{eGFR}{75}\right)^{0.658} \cdot [1 + 0.0106 \cdot (TBW - 90)] \cdot F_{ICU}FICU=0.845 if critically ill, else 1.0F_{ICU} = 0.845 \text{ if critically ill, else } 1.0V1=16.7V_1 = 16.7V2=23.1V_2 = 23.1V3=83.0V_3 = 83.0Q2=16.1Q_2 = 16.1Q3=2.44Q_3 = 2.44
LaTeX source
CL = 3.36 \cdot \left(\frac{eGFR}{75}\right)^{0.658} \cdot [1 + 0.0106 \cdot (TBW - 90)] \cdot F_{ICU}
F_{ICU} = 0.845 \text{ if critically ill, else } 1.0
V_1 = 16.7
V_2 = 23.1
V_3 = 83.0
Q_2 = 16.1
Q_3 = 2.44

Implementation notes

Three-compartment overweight/obese model. ICU status (from the ICU tag) lowers clearance 15.5%. CL uses CKD-EPI 2021 eGFR and total body weight.

Simulation settings

Models

selected

Dose candidates (mg)

Interval candidates (h)

Demographics

Physical characteristics.

kg
cm
yr