Accuracy and precision of the computer program for TDM of vancomycin in pediatric patients
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Abstract
Vancomycin mainly used for methicillin-resistant Staphylococcus aureus (MRSA) treatment. There was sparse data in the pediatrics that have pharmacokinetic variabilities of such patients. Vancomycin is narrow therapeutic index with a risk of severe toxicity. Computer program for therapeutic drug monitoring (TDM) is important for individualized pediatric patients provided the most effective and safety. Objective: To examine the accuracy and precision of the computer program for TDM of vancomycin in pediatric patients. Method: Retrospective study, collected data from vancomycin TDM records in 50 pediatric patients admitted at Queen Sirikit Heart Center of the Northeast aged less than 13 years old and received vancomycin during 16 September 2015 to 31 January 2016. Manually, the Sawchuk-Zaske method was used for pharmacokinetic parameter calculation. The results of manual and computer program calculation were compared using pair t-test statistic at 0.05 significant level Result: All 50 pediatric patients, the mean of elimination rate constant (Ke), half-life (t1/2), maximum and minimum concentration (Cmax, Cmin) calculated using the program calculation were, 0.248±0.07 hr-1,3.131±1.32 hr, 22.112±7.76 mg/L and 6.724±3.83 mg/L, respectively and using the manual calculation were 0.248±0.07 hr-1, 3.131±1.32hr, 22.310±7.59mg/L and 6.724±3.83 mg/L, respectively. The difference between the result of the program and manual calculation is not statistically significant at 0.05 significant level. For speed test of calculation, calculated time per one patient of using program was faster than manual calculation. Conclusion: The pharmacokinetic parameters which calculated by the program and manual calculation was not significantly different and the ability of program calculation is faster more than manual calculation. In the clinical setting, the computer program assisted TDM of vancomycin in pediatrics also can used for assured results that have accuracy and precision and for rapidly calculation.
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