Background: The use of vancomycin in critically ill patients is always challenging due to the pathophysiological changes
among this vulnerable group that may alter the pharmacokinetic and pharmacodynamic of vancomycin. Objectives: This study was
designed to identify the patient’s factors or covariates that might influence the development of vancomycin population
pharmacokinetic models and to determine the appropriate dosing regimen for critically ill patients. Methods: A literature search
was conducted independently between 2 reviewers from PubMed and Ovid databases from its inception until November 2020. The
data was extracted by one reviewer and was checked by another reviewer. Quality assessment was evaluated by using ROBINS-I
assessment tool while Cronbach’s alpha was used for reliability between the 2 reviewers. Results and discussion: A total of 7
studies were included with 1 study identified by checking the references of included papers. All studies showed a significant
reduction of objective function value (OFV) with P < 0.05 when body weight (BW) and creatinine clearance (CrCl) were included
in calculating volume of distribution (Vd) and clearance (Cl) of vancomycin respectively in the final model. Loading and
maintenance doses were recommended according to the CrCl, BW, age and CSF-albumin of the patients. Conclusions: The specific
pharmacokinetic parameter of this population should be identified to allow more precise individualisation of vancomycin dosing
for better efficacy and safety in the ICU setting. Therefore, therapeutic drug monitoring (TDM) vancomycin should be performed
to ensure better patient outcomes as well as to avoid vancomycin-induced nephrotoxicity and ototoxicity.
Key words: vancomycin; pharmacokinetic models; critically ill patients; dosing regimen
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