Journal of Research in Pharmacy Practice

The risk factors for cytomegalovirus reactivation following stem cell transplantation

. Bahareh Valadkhani; . Mona Kargar; . Asieh Ashouri; . Molouk Hadjibabaie; . Kheirollah Gholami; . Ardeshir Ghavamzadeh

Volume 5, Issue 1 , January 2016, , Pages 63-69

Abstract

Objective: Opportunistic infections like cytomegalovirus (CMV) are among the primary causes of morbidity and mortality in patients undergoing hematipoetic stem cell transplantation ... Read More

Predictive performance of Vancomycin population pharmacokinetic models in Iranian patients underwent hematopoietic stem cell transplantation

. Maryam Taghizadeh-Ghehi; . Saeed Rezaee; . Kheirollah Gholami; . Molouk Hadjibabaie

Volume 4, Issue 3 , July 2015, , Pages 129-134

Abstract

Objective: Many hematopoietic stem cell transplantation (HSCT) patients receive vancomycin empirically during febrile neutropenia. There are several models for estimation of vancomycin ... Read More Objective: Many hematopoietic stem cell transplantation (HSCT) patients receive vancomycin empirically during febrile neutropenia. There are several models for estimation of vancomycin pharmacokinetic parameters and calculation of initial dosing regimen accordingly. However, the performance of these methods in HSCT patients remained to be evaluated. The aim of the study was to determine which of the vancomycin population pharmacokinetic methods best fit Iranian HSCT patients.Methods: In order to evaluate predicted performance of seven vancomycin population pharmacokinetic models, the pharmacokinetic parameters of patients were estimated using each model’s equations. Then the predicted steady‑state trough vancomycin concentration was calculated based on each model’s parameters and using a formula based on Sawchuk–Zaske method. The predicted steady‑state trough vancomycin concentration and the real measured concentrations were compared to see which method was the most precise and least biased using mean squared error (MSE) and mean prediction error (ME) respectively.Findings: Forty‑six patients (65% men) were included in the study. Calculated metrics showed a range of 38% under‑prediction bias with Rodvold to 34% over‑prediction bias with Matzke and Burton models. Birt and revised Burton methods showed no significant bias(ME [95% confidence interval(CI)]: –0.067 [–0.235–0.101] and 0.066 [–0.105–0.238]). Birt and revised Burton were not different significantly considering MSE (95% CI) of 0.385 (0.227–0.544) and 0.401 (0.255–0.546), respectively. Comparisons of precision with naive predictors revealed a delta MSE (95% CI) of –0.128 (–1.379–1.890) for Birt and 0.026 (–0.596–0.940) for revised Burton models.Conclusion: Although the Birt and Burton revised methods performed well, none of the studied models showed acceptable performance to be implemented as a routine method for initial dose calculation in HSCT patients. A vancomycin pharmacokinetic model specific for this high‑risk subpopulation of Iranian patients should be designed and validated.

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Author = . Molouk Hadjibabaie

The risk factors for cytomegalovirus reactivation following stem cell transplantation

Abstract

Predictive performance of Vancomycin population pharmacokinetic models in Iranian patients underwent hematopoietic stem cell transplantation

Abstract