Bayesian Approach to AUC-Guided Vancomycin Monitoring in Adult Patients at Hung Ha General Hospital

Abstract

Objectives: This study aimed to analyze the results of vancomycin therapeutic drug monitoring (TDM) practice in adult patients in Hung Ha General Hospital by applying the area under the concentration-time curve (AUC) estimated by the Bayesian approach. Subjects and methods: This was a prospective observational study conducted on adult patients (18 years and older) who met the criteria of the vancomycin concentration monitoring procedure. The proposed vancomycin dosage regimen was estimated to achieve a target AUC₂₄/MIC within the optimal range of 400 – 600 mg.hour/L, using a Bayesian approach on the PrecisePK program. The study was conducted at Hung Ha General Hospital from August 1, 2023, to April 14, 2024. Results: The study involved a total of 30 adult patients with an average age of 59.2 ± 14.5 having TDM vancomycin in the study period. At the first TDM, 12/30 patients (40.0%) attained the target AUC. The follow-up dosage adjustment on 10 patients showed that 8/10 (80.0%) patients attained the target AUC. There was no AKI case recorded after treatment with vancomycin. Conclusion: The application of a Bayesian approach in TDM vancomycin improved the likelihood of achieving the target AUC₂₄/MIC 400 - 600, enhanced treatment efficacy, and reduced the risk of toxicity in patients.