バンコマイシン・ベイジアン・モデリングの定常状態前対定常状態濃度における対象内遡及的分析
Elizabeth W Covington1, Jihyun L Chae1, Sarah Grace Gunter2
1Harrison College of Pharmacy, Auburn University, Auburn, AL, USA.
まとめ
ベイジアンモデリングは,安定状態前の濃度を使用して,ヴァンコマイシン24時間の曲線下の面積 (AUC24) を正確に推定します. 安定状態の濃度を用いた計算はわずかなバイアスを示したが,全体的に一致し,安定状態前のレベルを使用した場合はカテゴリー不一致が少なくなった.
科学分野:
- 薬物動力学と薬物動力学
- 臨床薬局
- 計算モデリング
背景:
- ベイジアンモデリングは,バンコマイシン24時間の曲線下の面積 (AUC24) を安定状態前の濃度を使用して推定する.
- 安定状態と安定状態前のバンコマイシン濃度から得られたベイジアンAUC24の計算を比較する研究は限られている.
研究 の 目的:
- ベイジアンモデリングを用いて,安定状態前と安定状態の濃度から得られたバンコミシンAUC24の計算との一致を評価する.
- 異なる濃度採取時間に基づくバンコミシンAUC24の推定値の正確性と信頼性を比較する.
主な方法:
- 安定状態前と安定状態のバンコマイシン濃度の両方を持つ93人の患者による遡及コホート研究.
- ベイジアンAUC24の計算は,安定状態のレベルを含めても,含めても行われました.
- 合意はBland- Altmanグラフとバイアス分析のための線形回帰を用いて評価された.
主要な成果:
- 安定状態の値が隠されたときのAUC24の平均差は8. 8mg*h/ Lであり,安定状態前の値が隠されたときのAUC24の平均差は-3. 7mg*h/ Lであった.
- 均衡状態のレベルが隠されたときの比例バイアスは観察された (P = 0. 038),しかし,安定状態前のレベルが隠されたときのバイアスは観察されなかった.
- 安定状態のレベルが隠されたときのカテゴリー不一致率は,安定状態前のレベルが隠されたときの割合 (8%,P < 0. 001) よりも著しく高かった.
結論:
- バイエスのバンコミシンAUC24の計算は,安定状態の濃度を含めるかどうかにかかわらず,全体的に一致しています.
- 平均差は小さいが,バイエスの計算で安定状態レベルを使用すると,合意の限界が厳しくなる.
- バンコミシンAUC24の推定に関するこれらの発見を確認するために,より大きなコホートでのさらなる調査が必要である.
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