ArticleEuropean journal of drug metabolism and pharmacokinetics2026
Vancomycin Pharmacokinetics in Obese Patients: Insights from Bayesian Modeling.
Article in European journal of drug metabolism and pharmacokinetics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundOptimal vancomycin dosing in obese patients remains challenging due to altered pharmacokinetics and the variable relationship between trough concentrations and therapeutic exposure.
objectiveTo evaluate the pharmacokinetics of vancomycin and the attainment of therapeutic targets in obese patients using Bayesian software analysis.
methodsThis retrospective cohort study included adult inpatients (≥ 18 years) from six hospitals within the Legacy Health System (Oregon, USA) who received intravenous vancomycin for ≥ 48 h and had a steady-state level measured between August 2024 and March 2025. Patients on renal replacement therapy, with acute kidney injury, pregnancy, or ECMO were excluded. Vancomycin pharmacokinetic parameters were estimated using PrecisePK Bayesian software, and patients were categorized by body mass index (BMI): normal weight (n = 106), obese class 1 (n = 112), and obese class 2 or higher (n = 102).
resultsA total of 320 patients were included. Mean vancomycin clearance increased with BMI (4.32 ± 2.27 L/h in normal weight vs. 4.82 ± 2.82 L/h in obese class 2+; p < 0.05), and the volume of distribution was significantly greater in obese groups (56.3 ± 14.6 L vs. 70.5 ± 18.9 L; p < 0.05). Therapeutic AUC
conclusionsObesity significantly influences vancomycin clearance and distribution but does not affect the likelihood of achieving target AUC
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