Genetic Algorithms As a Tool for Dosing Guideline Optimization: Application to Intermittent Infusion Dosing for Vancomycin in Adults

Overview

Journal CPT Pharmacometrics Syst Pharmacol

Publisher Wiley

Specialty Pharmacology

Date 2020 May 9

PMID 32383808

Citations 1

Authors

Pieter J Colin

Douglas J Eleveld

Alison H Thomson

Affiliations

Soon will be listed here.

Abstract

This paper demonstrates the use of a genetic algorithm (GA) for the optimization of a dosing guideline. GAs are well-suited to derive combinations of doses and dosing intervals that go into a dosing guideline when the number of possible combinations rule out the calculation of all possible outcomes. GAs also allow for different constraints to be imposed on the optimization process to safeguard the clinical feasibility of the dosing guideline. In this work, we demonstrate the use of a GA for the optimization of intermittent vancomycin administration in adult patients. Constraints were placed on the dose strengths, the length of the dosing intervals, and the maximum infusion rate. In addition, flexibility with respect to the timing of the first maintenance dose was included in the optimization process. The GA-based optimal solution is compared with the Scottish Antimicrobial Prescribing Group vancomycin guideline.

Citing Articles

Evolutionary Mechanism Based Conserved Gene Expression Biclustering Module Analysis for Breast Cancer Genomics.

Yuan W, Li Y, Han Z, Chen Y, Xie J, Chen J Biomedicines. 2024; 12(9).

PMID: 39335599 PMC: 11428256. DOI: 10.3390/biomedicines12092086.

References

Heil E, Claeys K, Mynatt R, Hopkins T, Brade K, Watt I . Making the change to area under the curve-based vancomycin dosing. Am J Health Syst Pharm. 2018; 75(24):1986-1995. DOI: 10.2146/ajhp180034. View

Thomson A, Staatz C, Tobin C, Gall M, Lovering A . Development and evaluation of vancomycin dosage guidelines designed to achieve new target concentrations. J Antimicrob Chemother. 2009; 63(5):1050-7. DOI: 10.1093/jac/dkp085. View

Michalets E, Pounders C, Hollis S, Sutherland S . Outcomes associated with AUC24/MIC nomogram dosing of vancomycin. Ann Pharmacother. 2011; 45(5):687-9. DOI: 10.1345/aph.1P495. View

Ye Z, Chen Y, Chen K, Zhang X, Du G, He B . Therapeutic drug monitoring of vancomycin: a guideline of the Division of Therapeutic Drug Monitoring, Chinese Pharmacological Society. J Antimicrob Chemother. 2016; 71(11):3020-3025. DOI: 10.1093/jac/dkw254. View

Hughes J, Upton R, Reuter S, Phelps M, Foster D . Optimising time samples for determining area under the curve of pharmacokinetic data using non-compartmental analysis. J Pharm Pharmacol. 2019; 71(11):1635-1644. DOI: 10.1111/jphp.13154. View

Colin P, Allegaert K, Thomson A, Touw D, Dolton M, de Hoog M . Vancomycin Pharmacokinetics Throughout Life: Results from a Pooled Population Analysis and Evaluation of Current Dosing Recommendations. Clin Pharmacokinet. 2019; 58(6):767-780. DOI: 10.1007/s40262-018-0727-5. View

Yoon S, Park K, Lee S, Song S, Beom Park W, Jang I . Assessment of Appropriateness of an Initial Dosing Regimen of Vancomycin and Development of a New Dosing Nomogram. Basic Clin Pharmacol Toxicol. 2017; 122(2):233-238. DOI: 10.1111/bcpt.12873. View

Cockcroft D, GAULT M . Prediction of creatinine clearance from serum creatinine. Nephron. 1976; 16(1):31-41. DOI: 10.1159/000180580. View

Bies R, Muldoon M, Pollock B, Manuck S, Smith G, Sale M . A genetic algorithm-based, hybrid machine learning approach to model selection. J Pharmacokinet Pharmacodyn. 2006; 33(2):195-221. DOI: 10.1007/s10928-006-9004-6. View

10.

Zasowski E, Lodise T . The Importance of Individualized Vancomycin Dosing to Ensure Optimal Exposure Early in Therapy. J Clin Pharmacol. 2018; 58(9):1131-1133. DOI: 10.1002/jcph.1281. View

11.

Golenia B, Levine A, Moawad I, Yeh D, Arpino P . Evaluation of a vancomycin dosing nomogram based on the Modification of Diet in Renal Disease equation in intensive care unit patients. J Crit Care. 2013; 28(5):710-6. DOI: 10.1016/j.jcrc.2013.01.004. View

12.

Leu W, Liu Y, Wang H, Chien H, Liu H, Lin Y . Evaluation of a vancomycin dosing nomogram in achieving high target trough concentrations in Taiwanese patients. Int J Infect Dis. 2012; 16(11):e804-10. DOI: 10.1016/j.ijid.2012.07.005. View

13.

Pea F, Furlanut M, Negri C, Pavan F, Crapis M, Cristini F . Prospectively validated dosing nomograms for maximizing the pharmacodynamics of vancomycin administered by continuous infusion in critically ill patients. Antimicrob Agents Chemother. 2009; 53(5):1863-7. PMC: 2681515. DOI: 10.1128/AAC.01149-08. View

14.

Thalakada R, Legal M, Lau T, Luey T, Batterink J, Ensom M . Development and validation of a novel vancomycin dosing nomogram for achieving high-target trough levels at 2 canadian teaching hospitals. Can J Hosp Pharm. 2012; 65(3):180-7. PMC: 3379824. DOI: 10.4212/cjhp.v65i3.1140. View

15.

Matsumoto K, Takesue Y, Ohmagari N, Mochizuki T, Mikamo H, Seki M . Practice guidelines for therapeutic drug monitoring of vancomycin: a consensus review of the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring. J Infect Chemother. 2013; 19(3):365-80. DOI: 10.1007/s10156-013-0599-4. View

16.

Wesner A, Brackbill M, Coyle L, Kidd R . Prospective trial of a novel nomogram to achieve updated vancomycin trough concentrations. Interdiscip Perspect Infect Dis. 2013; 2013:839456. PMC: 3791841. DOI: 10.1155/2013/839456. View

17.

Medellin-Garibay S, Ortiz-Martin B, Rueda-Naharro A, Garcia B, Romano-Moreno S, Barcia E . Pharmacokinetics of vancomycin and dosing recommendations for trauma patients. J Antimicrob Chemother. 2015; 71(2):471-9. DOI: 10.1093/jac/dkv372. View

18.

Moore H . How to mathematically optimize drug regimens using optimal control. J Pharmacokinet Pharmacodyn. 2018; 45(1):127-137. PMC: 5847021. DOI: 10.1007/s10928-018-9568-y. View

19.

Semple Y, Bennie M, Sneddon J, Cockburn A, Seaton R, Thomson A . Development and evaluation of a national gentamicin and vancomycin quality improvement programme. J Antimicrob Chemother. 2020; 75(7):1998-2003. DOI: 10.1093/jac/dkaa096. View

20.

Kullar R, Leonard S, Davis S, Delgado Jr G, Pogue J, Wahby K . Validation of the effectiveness of a vancomycin nomogram in achieving target trough concentrations of 15-20 mg/L suggested by the vancomycin consensus guidelines. Pharmacotherapy. 2011; 31(5):441-8. DOI: 10.1592/phco.31.5.441. View