Population pharmacokinetics of vancomycin in patients with liver dysfunction
Abstract
Background and ObjectiveVancomycin is widely used in the treatment of serious infections caused by multidrug-resistant Gram-positive pathogens. However, the pharmacokinetic characteristics of vancomycin in patients with liver dysfunction remain inadequately characterized. This study aimed to develop a population pharmacokinetic (PopPK) model of vancomycin in patients with liver dysfunction and identify significant factors affecting plasma concentrations to guide individual therapy.MethodsIn this retrospective cohort study, clinical data were collected from patients with liver dysfunction. A nonlinear mixed effects model was employed to describe the influence of covariates on vancomycin pharmacokinetics and to obtain the final PopPK model. Goodness-of-fit plots, bootstrap analysis, and visual predictive checks were applied to assess the model stability and predictive performance.ResultsA total of 163 observable concentrations from 105 patients with liver dysfunction were included for PopPK modeling. A one-compartment model with first-order elimination best described the data, yielding a central volume of distribution (V) of 147.47 L and clearance (CL) of 4.40 L/h. Albumin (ALB) and estimated glomerular filtration rate (eGFR) were identified as significant covariates on V and CL in the final PopPK model, respectively. Model validation further demonstrated the excellent stability and predictive performance.ConclusionThe PopPK model incorporating ALB and eGFR can be used for model-informed precision dosing in this population, potentially improving target attainment of vancomycin and reducing the risk of nephrotoxicity.
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BibTeX
@article{bai2026population,
title = {{Population pharmacokinetics of vancomycin in patients with liver dysfunction}},
author = {Haihong Bai and Juping Yun and Zihe Wang and Wei Liu},
journal = {Frontiers in Pharmacology},
year = {2026},
month = nov,
doi = {10.3389/fphar.2026.2000197},
url = {https://www.frontiersin.org/articles/10.3389/fphar.2026.2000197},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Population pharmacokinetics of vancomycin in patients with liver dysfunction
AU - Haihong Bai
AU - Juping Yun
AU - Zihe Wang
AU - Wei Liu
PY - 2026
DA - 2026/11/02
JO - Frontiers in Pharmacology
DO - 10.3389/fphar.2026.2000197
UR - https://www.frontiersin.org/articles/10.3389/fphar.2026.2000197
AB - Background and ObjectiveVancomycin is widely used in the treatment of serious infections caused by multidrug-resistant Gram-positive pathogens. However, the pharmacokinetic characteristics of vancomycin in patients with liver dysfunction remain inadequately characterized. This study aimed to develop a population pharmacokinetic (PopPK) model of vancomycin in patients with liver dysfunction and identify significant factors affecting plasma concentrations to guide individual therapy.MethodsIn this retrospective cohort study, clinical data were collected from patients with liver dysfunction. A nonlinear mixed effects model was employed to describe the influence of covariates on vancomycin pharmacokinetics and to obtain the final PopPK model. Goodness-of-fit plots, bootstrap analysis, and visual predictive checks were applied to assess the model stability and predictive performance.ResultsA total of 163 observable concentrations from 105 patients with liver dysfunction were included for PopPK modeling. A one-compartment model with first-order elimination best described the data, yielding a central volume of distribution (V) of 147.47 L and clearance (CL) of 4.40 L/h. Albumin (ALB) and estimated glomerular filtration rate (eGFR) were identified as significant covariates on V and CL in the final PopPK model, respectively. Model validation further demonstrated the excellent stability and predictive performance.ConclusionThe PopPK model incorporating ALB and eGFR can be used for model-informed precision dosing in this population, potentially improving target attainment of vancomycin and reducing the risk of nephrotoxicity.
SN - 1663-9812
ER -