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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