万古霉素在不同人群中的药代动力学特征及个体化治疗研究进展OA

Objective To provide an evidence-based support for the development of individualized dosing regimens of vancomycin in clinical practice.Methods The recently published population pharmacokinetic studies and related guidelines on vancomycin were systematically analyzed.The research progress on pharmacokinetic characteristics and individualized therapy of vancomycin in different populations such as healthy adults,general inpatients,obese patients,elderly patients,pediatric patients,organ transplant recipients,burn patients,hematological tumor patients,neutropenia patients,and critically ill patients.Results Body mass,renal function,age,and specific disease status are key covariates affecting the pharmacokinetics of vancomycin in vivo.The latest therapeutic drug monitoring guideline recommends using the ratio of the 24-hour area under curve to the minimum inhibitory concentration(AUC0-24h/MIC)as the primary efficacy predictor instead of the traditional practice of trough concentration monitoring.Population pharmacokinetic models combined with Bayesian feedback can more accurately estimate individual pharmacokinetic parameters,thereby optimizing dosing regimens.Conclusion The pharmacokinetic characteristics of vancomycin vary significantly among different populations.Based on therapeutic drug monitoring,individualized dosing strategies guided by population pharmacokinetic models contribute to precise drug therapy and can improve patients'treatment outcomes.