Background: When administering vancomycin hydrochloride (VCM), the initial doseis adjusted to ensure that the steady-state trough value (Css-trough) remains withinthe effective concentration range. However, the Css-trough (population mean methodpredicted value [PMMPV]) calculated using the population mean method (PMM) oftendeviate from the effective concentration range. In this study, we used the generalizedlinear mixed model (GLMM) for initial dose planning to create a model that accuratelypredicts Css-trough, and subsequently assessed its prediction accuracy.Methods: The study included 46 subjects whose trough values were measured afterreceiving VCM. We calculated the Css-trough (Bayesian estimate predicted value [BEPV])from the Bayesian estimates of trough values. Using the patients’ medical data, we createdmodels that predict the BEPV and selected the model with minimum information criterion(GLMM best model). We then calculated the Css-trough (GLMMPV) from the GLMM bestmodel and compared the BEPV correlation with GLMMPV and with PMMPV.Results: The GLMM best model was {[0.977 + (males: 0.029 or females: -0.081)] ×PMMPV + 0.101 × BUN/adjusted SCr – 12.899 × SCr adjusted amount}. The coefficients ofdetermination for BEPV/GLMMPV and BEPV/PMMPV were 0.623 and 0.513, respectively.Conclusion: We demonstrated that the GLMM best model was more accurate inpredicting the Css-trough than the PMM.
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