ArticleEuropean journal of clinical pharmacology2019
The effect of neutropenia on the clinical pharmacokinetics of vancomycin in adults.
Article in European journal of clinical pharmacology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04758442 (Optimal Dosing of Vancomycin in an Adult Population of Hemato-oncology), which is not on this map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Optimal Dosing of Vancomycin in an Adult Population of Hemato-oncology: a Nomogram Based on a Bayesian Population Model to Predict Initial Dosage of Vancomycin
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- Precision Dosing of Vancomycin: A Systematic Review of Population Pharmacokinetics Models and Comparative Evaluation of Software Tools.Clinical pharmacokinetics · 2026Pooled it
- Population pharmacokinetics of a combination of miltefosine and paromomycin in Eastern African children and adults with visceral leishmaniasis.The Journal of antimicrobial chemotherapy · 2023Trial
- A Systematic Review of Pharmacokinetic Models of Vancomycin in Adult Patients (2020-2024): Trends, Variability, and Key Covariates.Current drug metabolism · 2025Article
- Towards precision dosing of vancomycin in patients with allogeneic hematopoietic stem cell transplantation: a comparison of published population pharmacokinetic models.Antimicrobial agents and chemotherapy · 2025Article
- Subgroup-based model selection to improve the prediction of vancomycin concentrations.Antimicrobial agents and chemotherapy · 2025Article
- Identifying the Optimal Sampling Strategy for the Bayesian Estimation of Vancomycin AUCClinical pharmacokinetics · 2025Article
- Pharmacokinetic variability of vancomycin in patients undergoing hematopoietic stem cell transplantation: a retrospective cohort study in Peru.Therapeutic advances in drug safety · 2025Article
- Selecting the Best Pharmacokinetic Models for a Priori Model-Informed Precision Dosing with Model Ensembling.Clinical pharmacokinetics · 2024Article
- Determination of a vancomycin nephrotoxicity threshold and assessment of target attainment in hematology patients.Pharmacology research & perspectives · 2024Article
- Toward Model-Based Informed Precision Dosing of Vancomycin in Hematologic Cancer Patients: A First Step.Clinical pharmacokinetics · 2024Article
- Altered Pharmacokinetics Parameters of Vancomycin in Patients with Hematological Malignancy with Febrile Neutropenia, a Bayesian Software Estimation.Antibiotics (Basel, Switzerland) · 2023Article
- Pharmacokinetics of Vancomycin among Patients with Chemotherapy-Associated Febrile Neutropenia: Which Would Be the Best Dosing to Obtain Appropriate Exposure?Antibiotics (Basel, Switzerland) · 2022Article
- Assessment of Micafungin Dosage Regimens in Patients with Cancer Using Pharmacokinetic/Pharmacodynamic Modeling and Monte Carlo Simulation.Antibiotics (Basel, Switzerland) · 2021Article
- Causes of vancomycin dosing error; problem detection and practical solutions; a retrospective, single-center, cross-sectional study.Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society · 2021Article
- Prospective validation of a model-informed precision dosing tool for vancomycin in intensive care patients.British journal of clinical pharmacology · 2020Article
- An Update on Population Pharmacokinetic Analyses of Vancomycin, Part I: In Adults.Clinical pharmacokinetics · 2020Review
- A Systematic Review of Vancomycin Dosing in Patients with Hematologic Malignancies or Neutropenia.Infection and drug resistance · 2020Review
- Is vancomycin clearance really correlated with hemoglobin? Arguments that it's not.European journal of clinical pharmacology · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimThere is accumulating evidence that neutropenic patients require higher dosages of vancomycin. To prevent sub-therapeutic drug exposure, it is of utmost importance to obtain adequate exposure from the first dose onwards. We aimed to quantify the effect of neutropenia on the pharmacokinetics of vancomycin.
methodsData were extracted from a matched patient cohort of patients known with (1) hematological disease, (2) solid malignancy, and (3) patients not known with cancer. Pharmacokinetic analysis was performed using non-linear mixed effects modeling with neutropenia investigated as a binary covariate on clearance and volume of distribution of vancomycin.
resultsA total of 116 patients were included (39 hematologic patients, 39 solid tumor patients, and 38 patients not known with cancer). In total, 742 paired time-concentration observations were available for the pharmacokinetic analysis. Presence of neutropenia showed to significantly (p = 0.00157) increase the clearance of vancomycin by 27.7% (95% CI 10.2-46.2%), whereas it did not impact the volume of distribution (p = 0.704).
conclusionsThis study shows that vancomycin clearance is increased in patients with neutropenia by 27.7%. Therefore, the vancomycin maintenance dose should be pragmatically increased by 25% in neutropenic patients at the start of treatment. Since the volume of distribution appeared unaffected, no adjustment in loading dose is required. These dose adjustments do not rule out the necessity of further dose individualization by means of therapeutic drug monitoring.
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Registered trials
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