Evaluation of the Predictive Ability of Individualization Dosage Auxiliary Software for Vancomycin Trough Concentration in Surgical Patients with Infective Endocarditis
10.3870/j.issn.1004-0781.2025.02.024
- VernacularTitle:个体化给药辅助软件对感染性心内膜炎手术患者万古霉素谷浓度预测能力评估
- Author:
Zhengyue QIAN
1
;
Yao FU
;
Chaohui JING
;
Xiaosong RONG
Author Information
1. 南京医科大学附属无锡人民医院药学部,无锡 214023
- Publication Type:Journal Article
- Keywords:
Vancomycin;
Infective endocarditis;
Therapeutic drug monitoring;
Predictive performance
- From:
Herald of Medicine
2025;44(2):314-319
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the predictive efficacy of individualized dosage support software-Smart Dose,PharmVan and JPKD-on vancomycin plasma concentration in patients undergoing infective endocarditis(IE)surgery,and to analyze the influencing factors.Methods A retrospective analysis was conducted in IE patients who received intravenous vancomycin in our hospital from January 2019 to December 2022.The above softwares were used to predict the steady-state trough concentration of vancomycin,and the relative prediction error and absolute weight deviation(AWE)between the predicted and measured values were compared.According to the AWE value,the results were divided into accurate prediction group(AWE＜30％)and the inaccurate prediction group(AWE≥30％).Univariate analysis and Logistic regression analysis were used to explore the influencing factors,and to evaluate the predictive value through the receiver operating characteristic curve(ROC).Results A total of 27 patients were enrolled,with 27 concentrations of initial regimen and 35 of adjustment regimen.When PharmVan predicted the adjusted concentration,the AWE was 24.84(11.54,39.78)％,with higher accuracy than other predicted results.The Univariate analysis of factors influencing the performance of PharmVan in predicting the adjusted concentration showed that patients in the accurate prediction group was significantly younger than that in the inaccurate prediction group(P＜0.05).Multivariate analysis showed that advanced age was an independent risk factor for the inaccurate prediction of PharmVan for adjustment concentration[OR=0.856,95％CI was(0.757,0.969),P=0.014].ROC curve analysis indicated that when patients were older than 48.5 years old,the risk of inaccurate prediction was increased with a sensitivity of 78.9％and a specificity of 93.7％.Conclusions Only the PharmVan software has a higher accuracy in predicting the adjusted concentration among the three softwares,but it is still need to be cautious in combination with the analysis results of ROC curve.Therefore,when using vancomycin in IE patients,attention should be paid to renal function and plasma concentration should be actively monitored.
