Development of decision system for individualization of vancomycin dosage
10.16438/j.0513-4870.2017-0673
- VernacularTitle:万古霉素个体化给药决策支持系统的研制
- Author:
Yu-cheng GAO
1
;
Zheng JIAO
1
;
Hong HUANG
2
;
Chen XIE
3
;
Jian-jun GAO
3
;
Liang ZHANG
1
;
Jie FANG
4
;
Wei-wei LIN
5
;
Yi-xi LIU
1
;
Ye GONG
6
Author Information
1. Department of Pharmacy, Huashan Hospital, Fudan University, Shanghai 200040, China
2. Department of Medical Information, Huashan Hospital, Fudan University, Shanghai 200040, China
3. Microsoft Corporation, Shanghai 200030, China
4. Department of Pharmacy, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
5. Department of Pharmacy, First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
6. Department of Critical Care Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
- Publication Type:ORIGINAL ARTICLES
- Keywords:
vancomycin;
dose individualization;
decision support system;
population pharmacokinetic;
maximum a posteriori Bayesian estimation
- From:
Acta Pharmaceutica Sinica
2018;53(1):104-110
- CountryChina
- Language:Chinese
-
Abstract:
Vancomycin has been widely prescribed as the first-line antibiotic in the treatment of methicillin-resistant Staphylococcus aureus and other serious Gram-positive infections. Due to its large pharmacokinetic (PK) variability and narrow therapeutic range, it requires optimization of dosage to achieve target exposure. In this study, SmartDose, a decision support system for individualization of vancomycin dosage is developed using the maximum a posterior Bayesian estimation (MAPB) by the open-source language R combined with the population PK characteristics of vancomycin in Chinese patients. It provides initial design and adjustment of dose regimens based on the therapeutic drug monitoring (TDM) results, as well as a user-defined module to facilitate optimal vancomycin therapy. SmartDose has a high computational reliability, which is validated by NONMEM, the golden standard PK software. Meanwhile, SmartDose is established as a web-based application and its operational flexibility makes it an efficient tool for vancomycin dose optimization in routine clinical settings.
