암환자에서 반코마이신의 집단약물동태학 모델연구

Population Pharmacokinetic Modeling of Vancomycin in Patients with Cancer

The purpose of this study was to determine pharmacokinetic parameters of vancomycin using peak and trough plasma level (PTL) and Bayesian analysis in 20 Korean normal volunteers, 16 gastric cancer and 12 lymphoma patients and also using the compartment model dependent (nonlinear least squares regression: NLSR) and compartment model independent (Lagrange) analysis in 10 o-varian cancer patients. Nonparametric expected maximum (NPEM) algorithm for calculation of the population pharmacokinetic parameters was used, and these parameters were applied for clinical pharmacokinetic parameters by Bayesian analysis. Vancomycin was administered as dose of 1.0g every 12 hrs for 3 days by IV infusion over 60 minutes in normal volunteers, gastric cancer and lymphoma patients and was administered at the same dose by IV infusion over 60 minutes in ovarian cancer patients. Population pharmacokinetic parameters, K and Vd in gastric cancer and lymphoma patients using NPEM algorithm were 0.158+/-014 hr-1. 0.630+/-0.043L/kg and 0.131+/-0261hr-1, 0.631+/-0.089L/kg respectively. The K and Vd in gastric cancer and lymphoma patients using Bayesian analysis were 0.151+/-0.027, 0.126+/-0.056hr-1 and 0.62+/-0.105, 0.63+/-0.095L/kg. The K and Vd in ovarian cancer patient using the NLSR and Lagrange analysis were 0.109+/-0.008, 0.126+/-0.012hr-1 and 0.76+/-0.08, 0.69+/-0.19L/kg, respectively. It is necessary for effective dosage regimen of vancomycin in cancer patients to use these population parameters.