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논문분류	춘계학술대회 초록집
제목	Predictive Performance of Bayesian-Derived and Linear Pharmacokinetic Calculation for Vancomycin Monitoring in Patients With Chronic Kidney Disease
저자	Wanchana Singhan
출판정보	2025; 2025(1):
키워드	vancomycin, chronic kidney disease, therapeutic drug monitoring, Baysian-derived calculation, linear pharmacokinetic
초록	The predictive performance of different calculation methods to predict vancomycin trough concentration (Ctrough) among patients with chronic kidney disease (CKD) remains unknown. This study was conducted to evaluate predictive performance of Bayesian-derived (Bpop) and linear pharmacokinetic (PK) calculation methods (Lpop) using population PK parameters in predicting vancomycin concentration in CKD patients. Patient characteristics and clinical data on the vancomycin initiation date were used to predict Ctrough. The bias and precision of the two methods were determined using mean prediction error (MPE), mean percentage prediction error (MPPE), mean absolute prediction error (MAPE), and root mean square prediction error (RMSE). A clinical decision agreement between the predicted and measured Ctrough was also assessed. The median [interquartile range] estimated glomerular filtration rate among 96 patients was 13.0 [7.0-29.0] mL/min/1.73 m2. MPE and MPPE were -1.84 µg/mL and -0.61% for Bpop; -0.77 µg/mL and 5.36% for Lpop, respectively. MAPE and RMSE were 35.55% and 6.74 µg/mL for Bpop; 43.98% and 6.90 µg/mL for Lpop, respectively. The clinical decision agreement with measured Ctrough for Bpop and Lpop were 50.0% and 43.8%, respectively. Both calculation methods demonstrated an underestimation in approximately one third of cases. Therapeutic drug monitoring with close Ctrough monitoring is the preferred approach in this population until a more precise calculation method is established.
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