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Development of decision system for individualization of vancomycin dosage
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Yu-cheng GAO1, Zheng JIAO1, *, Hong HUANG2, Chen XIE3, Jian-jun GAO3, Liang ZHANG1, Jie FANG4, Wei-wei LIN5, Yi-xi LIU1, 6, Ye GONG7
Acta Pharmaceutica Sinica | 2018, 53(1) : 104 - 110
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Acta Pharmaceutica Sinica | 2018, 53(1): 104-110
• ORIGINAL ARTICLES •
Development of decision system for individualization of vancomycin dosage
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Yu-cheng GAO1, Zheng JIAO1, *, Hong HUANG2, Chen XIE3, Jian-jun GAO3, Liang ZHANG1, Jie FANG4, Wei-wei LIN5, Yi-xi LIU1, 6, Ye GONG7
Affiliations
  • 1. Department of Pharmacy, Huashan Hospital, Fudan University, Shanghai 200040, China
  • 2. Department of Medical Information, Huashan Hospital, Fudan University, Shanghai 200040, China
  • 3. Microsoft Corporation, Shanghai 200030, China
  • 4. Department of Pharmacy, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
  • 5. Department of Pharmacy, First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
  • 6. School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing 211198, China
  • 7. Department of Critical Care Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
Published: 2018-01-12 doi: 10.16438/j.0513-4870.2017-0673
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Vancomycin has been widely prescribed as the first-line antibiotic in the treatment of methicillin-resistant Staphylococcus aureus and other serious Gram-positive infections. Due to its large pharmacokinetic (PK) variability and narrow therapeutic range, it requires optimization of dosage to achieve target exposure. In this study, SmartDose, a decision support system for individualization of vancomycin dosage is developed using the maximum a posterior Bayesian estimation (MAPB) by the open-source language R combined with the population PK characteristics of vancomycin in Chinese patients. It provides initial design and adjustment of dose regimens based on the therapeutic drug monitoring (TDM) results, as well as a user-defined module to facilitate optimal vancomycin therapy. SmartDose has a high computational reliability, which is validated by NONMEM, the golden standard PK software. Meanwhile, SmartDose is established as a web-based application and its operational flexibility makes it an efficient tool for vancomycin dose optimization in routine clinical settings.

vancomycin  /  dose individualization  /  decision support system  /  population pharmacokinetic  /  maximum a posteriori Bayesian estimation
Yu-cheng GAO, Zheng JIAO, Hong HUANG, Chen XIE, Jian-jun GAO, Liang ZHANG, Jie FANG, Wei-wei LIN, Yi-xi LIU, Ye GONG. Development of decision system for individualization of vancomycin dosage[J]. Acta Pharmaceutica Sinica, 2018 , 53 (1) : 104 -110 . DOI: 10.16438/j.0513-4870.2017-0673
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Article Info
doi: 10.16438/j.0513-4870.2017-0673
  • Receive Date：2017-07-11
  • Online Date：2026-01-15
  • Published：2018-01-12
Article Data
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History
  • Received：2017-07-11
  • Revised：2017-10-01
Funding
Affiliations
    1. Department of Pharmacy, Huashan Hospital, Fudan University, Shanghai 200040, China
    2. Department of Medical Information, Huashan Hospital, Fudan University, Shanghai 200040, China
    3. Microsoft Corporation, Shanghai 200030, China
    4. Department of Pharmacy, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
    5. Department of Pharmacy, First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
    6. School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing 211198, China
    7. Department of Critical Care Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
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表12种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
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Genus		 种数
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Percentage of total
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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