Scoping review on population pharmacokinetics of vancomycin in non-critically ill

Abstract

Background: Vancomycin is an effective first-line therapy in MRSA infection, however, achieving an appropriate serum concentration is challenging. Population pharmacokinetics can assist the clinician in the selection of better regimen dosing and improve effectiveness and safety outcomes. Methods: This scoping review aims to outline the evidence in population pharmacokinetic models in non-critical adults hospitalized from 1980 to 2021 and describe the principal software and covariables used in this. A total of 209 papers were fully screened. Finally, we included 17 articles conducted in different locations around the world. Results: This review identified 13 retrospective articles and 4 prospective, 5 describing the use in a general population with gram-positive bacterial infection, 11 evaluated special populations (older, obese, and cancer patients), and 1 mixed population. The main parameters in the models were renal clearance and volume of distribution. The principal covariables that affected the models were creatinine clearance and weight. All studies use internal validation methods, and three of them used an external validation group. This scoping review highlights the principal information of different population pharmacokinetic models and the heterogeneity in the parameters and methods of evaluation. Conclusions: These methods can be used to guide the dosing regimen in different subpopulations. However, it is imperative to define the best fit in every population and conduct an experiment due to the high variability in the present studies.