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Evaluation of a Two‐Compartment Bayesian Forecasting Program for Predicting Vancomycin Concentrations

 

作者: Keith Rodvold,   Randy Pryka,   Mark Garrison,   John Rotschafer,  

 

期刊: Therapeutic Drug Monitoring  (OVID Available online 1989)
卷期: Volume 11, issue 3  

页码: 269-275

 

ISSN:0163-4356

 

年代: 1989

 

出版商: OVID

 

关键词: Bayesian forecasting;Vancomycin;Serum concentration;Pharmacokinetics.

 

数据来源: OVID

 

摘要:

Summary: The application of a two-compartment Bayesian forecasting program for vancomycin was tested retrospectively in 45 adult patients with stable renal function. Serial blood samples from 25 of these patients were used to determine population-based parameter estimates. The predictive performance of the Bayesian program was assessed by using both non-steady-state and steady-state vancomycin concentrations as feedback information. Overall, the program tended to underpredict peak and trough steady-state vancomycin serum concentrations. A larger mean prediction error (ME) was seen when non-steady-state feedback serum concentrations were used compared with using population-based parameter estimates (no feedback). In contrast, a marked improvement in ME (peaks: −1.03 versus −2.61; troughs: −1.60 versus −2.07) was seen when steady-state feedback serum concentrations were used compared with no feedback data. Precision improved when either feedback serum concentrations were used to predict steady-state peak and trough vancomycin concentrations. The results from this clinical evaluation demonstrate that the initial pharmacokinetic parameter estimates for a two-compartment Bayesian model provided accurate prediction of steady-state vancomycin concentrations. Prediction bias and precision were improved when steady-state vancomycin concentrations were used to determine individualized pharmacokinetic parameters.

 

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