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Related Concept Videos

Dosage Regimens: Partial Pharmacokinetic Parameters01:01

Dosage Regimens: Partial Pharmacokinetic Parameters

It is not uncommon for complete drug pharmacokinetic profiles to remain elusive in pharmacokinetics. This necessitates certain educated assumptions by pharmacokineticists to determine appropriate dosage regimens without comprehensive pharmacokinetic data from animal or human studies. One prevalent assumption is setting the bioavailability factor, denoted as F, to 1 or 100%. This assumption caters to the scenario where a drug doesn't achieve full systemic absorption, resulting in the patient...
Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations01:15

Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations

Gentamicin, an aminoglycoside antibiotic, is commonly administered via intermittent intravenous infusion to treat severe infections. An intermittent one-hour infusion of gentamicin, administered at eight-hour intervals, allows for precise control of plasma drug concentrations, minimizing toxicity while ensuring therapeutic efficacy. Pharmacokinetic principles govern the dynamics of plasma concentrations and can be mathematically described using specific equations.The plasma drug concentration...
Determination of Multiple Dosing Parameters: Loading and Maintenance Doses01:25

Determination of Multiple Dosing Parameters: Loading and Maintenance Doses

A loading dose is an essential pharmacological strategy to rapidly achieve the target plasma drug concentration necessary for an immediate therapeutic effect. This approach is especially critical for drugs characterized by slow absorption or extended half-lives, where delaying therapeutic plasma levels could compromise treatment outcomes. By administering a loading dose, clinicians ensure a prompt onset of drug action, even for agents with complex pharmacokinetic profiles.Achieving steady-state...
Estimation of k and VD of Aminoglycosides01:20

Estimation of k and VD of Aminoglycosides

Aminoglycosides are a class of antibiotics used to treat various bacterial infections. Clinicians must determine the elimination rate constant (k) and volume of distribution (VD) to optimize therapeutic efficacy and minimize toxicity. The k value represents the rate at which the drug is removed from the body, and the VD reflects the degree to which the drug distributes into body tissues. Accurately estimating these parameters allows healthcare professionals to tailor drug dosing to individual...
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...

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Nanomechanics of Drug-target Interactions and Antibacterial Resistance Detection
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Model-Informed Precision Dosing of Vancomycin in Vietnamese Children: Innovative Midpoint Concentration Monitoring

Ba Hai Le1, Chi Kien Phung1, Olivia Yip2

  • 1Department of Clinical Pharmacy, Hanoi University of Pharmacy, Hanoi, Vietnam.

Therapeutic Drug Monitoring
|March 28, 2025
PubMed
Summary
This summary is machine-generated.

Midpoint vancomycin concentration monitoring accurately assesses pediatric patients, offering a convenient alternative to the standard 2-sample method. An open-source software, Shiny, provides a viable Bayesian model-informed precision dosing tool for clinical use.

Keywords:
Bayesian approachVietnamese childrenmodel-informed precision dosingtherapeutic drug monitoringvancomycin

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11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

Area of Science:

  • Pharmacology
  • Pediatric Medicine
  • Computational Biology

Background:

  • Bayesian area under the curve (AUC)-guided vancomycin dosing with 2 samples (2S) is recommended for pediatric patients.
  • Clinical implementation of model-informed precision dosing (MIPD) is limited in low- to middle-income countries due to high software costs.
  • This study compares midpoint and 2S sampling strategies for vancomycin dosing accuracy and evaluates open-source software for MIPD.

Purpose of the Study:

  • To compare the accuracy and precision of midpoint versus guideline-recommended 2-sample (2S) vancomycin dosing strategies in pediatric patients using Bayesian analysis.
  • To evaluate the clinical utility of an open-source software package (Shiny) for Bayesian MIPD of vancomycin in children.
  • To compare the performance of Shiny with a commercial software (PrecisePK).

Main Methods:

  • Retrospective cohort study at 2 pediatric hospitals (April 2022-April 2023).
  • Enrolled patients aged 3 months to 16 years receiving vancomycin with at least 2 measured concentrations (Cmax, Cmid, Ctrough).
  • Calculated accuracy and precision of pharmacokinetic parameters using Bayesian analysis.

Main Results:

  • Eighty pediatric patients with 226 vancomycin concentrations were analyzed.
  • Midpoint sampling showed high accuracy (5.02%) and precision (6.45%) for Bayesian-derived AUC24 compared to the 2S method.
  • The open-source Shiny software demonstrated comparable accuracy (-5.58%) and precision (6.09%) to PrecisePK for AUC24 estimation.

Conclusions:

  • Midpoint vancomycin concentration monitoring is a convenient and accurate method for hospitalized pediatric patients.
  • The open-source Shiny software is a viable Bayesian MIPD tool for vancomycin dosing and monitoring in children, particularly in resource-limited settings like Vietnam.