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Belz, Sarah N.; Seabury, Robert W.; Steele, Jeffrey M.; Darko, William; Miller, Christopher D.; Probst, Luke A.; Kufel, Wesley D.

Accuracy of 4 Free Online Dosing Calculators in Predicting the Vancomycin Area Under the Concentration-Time Curve Calculated Using a 2-Point Pharmacokinetic Approach

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  • Media type: E-Article
  • Title: Accuracy of 4 Free Online Dosing Calculators in Predicting the Vancomycin Area Under the Concentration-Time Curve Calculated Using a 2-Point Pharmacokinetic Approach
  • Contributor: Belz, Sarah N.; Seabury, Robert W.; Steele, Jeffrey M.; Darko, William; Miller, Christopher D.; Probst, Luke A.; Kufel, Wesley D.
  • imprint: SAGE Publications, 2023
  • Published in: Annals of Pharmacotherapy
  • Language: English
  • DOI: 10.1177/10600280221117256
  • ISSN: 1060-0280; 1542-6270
  • Keywords: Pharmacology (medical)
  • Origination:
  • Footnote:
  • Description: <jats:sec><jats:title>Background:</jats:title><jats:p> Free online adaptive vancomycin dosing calculators are available to estimate area under the concentration-time curve (AUC), but the accuracy of predicting vancomycin AUC using these calculators compared with using a 2-point pharmacokinetic approach has not been described. </jats:p></jats:sec><jats:sec><jats:title>Objective:</jats:title><jats:p> To evaluate the accuracy of calculator-predicted AUC (cpAUC) using 4 free online calculators compared with reference AUC (rAUC), and to assess pharmacists’ impressions of the ease of use. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> Vancomycin AUC was estimated using (1) the reference method via the Sawchuk-Zaske method and linear-logarithmic trapezoidal rule using 2 steady-state postdistributional vancomycin serum concentrations and (2) 4 free online vancomycin dosing calculators including ClinCalc, VancoPK, TDMx, and DMC. Accuracy was calculated by dividing cpAUC by rAUC. Ease of cpAUC estimation was determined by using a 10-point Likert scale. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> All 4 calculators had a median cpAUC accuracy ranging from 89% to 110%. Concordance between cpAUC and rAUC determinations of AUC &lt;400 and &gt; 600 mg·h/L occurred 63.3% to 71.4% and 74.5% to 78.6% of the time, respectively. Pharmacist investigators agreed that ClinCalc and VancoPK calculators were easiest to use. </jats:p></jats:sec><jats:sec><jats:title>Conclusion and Relevance:</jats:title><jats:p> cpAUC accuracy varied among the 4 calculators, but all consistently identified patients with an rAUC &lt;400 mg·h/L and an rAUC &gt; 600 mg·h/L at comparable frequencies. All 4 calculators demonstrated some imprecision based on their wide 95% CIs and potential inaccuracies in predicting an rAUC &lt;400 mg·h/L or an rAUC &gt; 600 mg·h/L. Clin Calc and VancoPK were most user friendly based on our pharmacists’ impressions. </jats:p></jats:sec>