PHARMACOKINETIC MODELING AND PK / PD CORRELATION OF VANCOMYCIN
Pharmacokinetics, pharmacodynamics, monitoring, vancomycin.
Introduction: Although the criteria for monitoring drugs in critically ill patients are much clearer today, the proportion of patients receiving this service is still much lower than necessary in hospitals in Brazil. Monitoring through the principle of pharmacokinetics and pharmacodynamics (Pk / Pd) in critically ill patients aims to meet the needs of dose, concentration and ideal effect for the patient, with improvement in the clinical outcome and decrease in the likelihood of developing bacterial resistance. In this sense, this work aims to evaluate the different pharmacokinetic and pharmacodynamic profiles (PK / PD) of a population. Methods: This is a cross-sectional, documentary study. The research was based on information, the medical records of critically ill patients at the co-participant institution who used the drug vancomycin and who were subjected to drug monitoring during use. Individual patient data were collected from medical records. To determine the pharmacokinetic profiles of Vancomycin, as well as to model the population pharmacokinetics of this drug, the Bayesian tool was used, using the Monolix® software. To determine the pharmacodynamic profile, EUCAST data (European Committee for Antimicrobial Susceptibility Tests) with mic values of 0.125.0.25, 0.5, 1. Results: The vancomycin PK profile was well characterized by a one-compartment model with age covariates and serum creatinine, statistically influencing clearance (CL) and volume of distribution (V). The population clarence value was 1.52 L / h and the volume of distribution was 192.49 L. Of the dialysis patients, only 20% had full coverage for all Mics and of the patients without dialysis, 17% were fully protected. Conclusion: The pharmacokinetics of vancomycin in the population studied were significantly affected by creatinine and age. The pk / pd correlation across the area on the curve (AUC / MIC> 400) demonstrated that the standard doses administered were not able to guarantee the efficiency of treatment for all patients on dialysis or not.