Scoping review on population pharmacokinetics of vancomy- 2 cin in hospitalized adults

Abstract

Vancomycin is an effective first-line therapy in MRSA infection, however, achieving an 13 appropriate serum concentration is challenging. Population pharmacokinetics can offer assistance 14 to the clinician in the selection of better regimen dosing and improve effectiveness and safety out- 15 comes. This scoping review aims to outline the evidence in population pharmacokinetic models in 16 non-critical adults hospitalized from 1980 to 2021 and describe the principal software and covaria- 17 bles used in this. A total of 209 papers were fully screened. Finally, we included 17 articles con- 18 ducted in different locations around the world. This review identified 13 retrospective articles and 19 4 prospective, 5 describing the use in a general population with gram-positive bacterial infection, 20 11 evaluated special populations (older, obese, and cancer patients), and 1 mixed population. The 21 main parameters in the models were renal clearance and volume of distribution. The principal co- 22 variables that affected the models were creatinine clearance and weight. All studies use internal 23 validation methods, and three of them used an external validation group. This scoping review high- 24 lights the principal information of different population pharmacokinetic models and the heteroge- 25 neity in the parameters and methods of evaluation. These methods can be used to guide the dosing 26 regimen in different subpopulations. However, it is imperative to define the best fit in every popu- 27 lation and conduct an experiment due to the high variability in the present studies.