Population pharmacokinetic analysis of vancomycin in patients with gram-positive infections and the influence of infectious disease type.

OBJECTIVE: To describe the population pharmacokinetics of vancomycin in patients with gram-positive infections and to investigate the influence of type of infectious disease.

METHODS: A two-compartment open model was adopted as a pharmacokinetic model. The nonlinear mixed-effects model was used to analyze the population pharmacokinetic models.

RESULTS: We propose one general model and one infectious disease type-specific model. The general model showed that vancomycin clearance (CL) was linearly correlated with estimated creatinine clearance (CL(CR)) when CL(CR) was less than 85 mL/min, as expressed by CL(L/h) = 0.0322 x CL(CR) + 0.32. The distribution volumes of the central and peripheral compartment were different in healthy volunteers and patients with gram-positive infections. The infectious disease type-specific model showed that these differences were more pronounced in patients with pneumonia.

CONCLUSION: The population pharmacokinetic parameters of vancomycin obtained here can be used to individualize the dosage of vancomycin in institutions with similar patient population characteristics.