---
title: "Vancomycin practical antimicrobial TDM in Japanese critical care: correcting overestimated concent"
id: "pubmed-42687843"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42687843"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42687843/"
doi: "10.5414/CP205029"
published_at: "2026-09-03T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Vancomycin practical antimicrobial TDM in Japanese critical care: correcting overestimated concent
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42687843
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42687843/)
- **DOI:** [10.5414/CP205029](https://doi.org/10.5414%2FCP205029)
- **Published At:** 2026-09-03T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Study aim: Improve initial dosing accuracy for **vancomycin** using a free practical antimicrobial TDM (**PAT**) web application, identify subgroups in emergency and critical care with overestimated predicted concentrations (**PRED**), and calculate PRED scaling factors. - Design: Simulation of vancomycin serum concentrations using a population pharmacokinetic model applied to patients at the University of Miyazaki Hospital Emergency and Critical Care Centers. Observed-to-predicted ratios (OBS/PRED) guided subgroup assignment. - Classification: Patients with OBS/PRED 15 mL/min; this adjustment reduced root mean squared error (**RMSE**) from 5.1 to 4.0 μg/mL between PRED and OBS. - Outcome measures: Mean squared error (MSE) and RMSE between predicted and observed concentrations were compared before and after applying scaling factors. - Conclusion: Applying PRED scaling factors may improve initial vancomycin dosing accuracy in PAT; ΔCCR > 15 mL/min, ΔALB < –0.5 g/dL, and trauma were key indicators for adjustment. - Reporting gaps: The abstract does not report full population pharmacokinetic model details, exact PAT web application workflow, dosing regimens used, timing of concentration sampling, or statistical significance levels for all comparisons.
## Clinical Analysis & Structured Key Points
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Online ahead of print. # Practical antimicrobial TDM (PAT) of vancomycin in Japanese emergency and critical care units: Concentration overestimation and correction using scaling factors [Koki Takeda](https://pubmed.ncbi.nlm.nih.gov/?term=Takeda+K&cauthor_id=42687843), [Naoki Yoshikawa](https://pubmed.ncbi.nlm.nih.gov/?term=Yoshikawa+N&cauthor_id=42687843), [Hidehiko Koreeda](https://pubmed.ncbi.nlm.nih.gov/?term=Koreeda+H&cauthor_id=42687843), [Shuhei Urata](https://pubmed.ncbi.nlm.nih.gov/?term=Urata+S&cauthor_id=42687843), [Yuki Matsusaki](https://pubmed.ncbi.nlm.nih.gov/?term=Matsusaki+Y&cauthor_id=42687843), [Tsubasa Yokota](https://pubmed.ncbi.nlm.nih.gov/?term=Yokota+T&cauthor_id=42687843), [Akira Okada](https://pubmed.ncbi.nlm.nih.gov/?term=Okada+A&cauthor_id=42687843), [Ayane Higuchi](https://pubmed.ncbi.nlm.nih.gov/?term=Higuchi+A&cauthor_id=42687843), [Rin Taguchi](https://pubmed.ncbi.nlm.nih.gov/?term=Taguchi+R&cauthor_id=42687843), [Asako Nishimura](https://pubmed.ncbi.nlm.nih.gov/?term=Nishimura+A&cauthor_id=42687843), [Nobuhito Shibata](https://pubmed.ncbi.nlm.nih.gov/?term=Shibata+N&cauthor_id=42687843), [Ryota Tanaka](https://pubmed.ncbi.nlm.nih.gov/?term=Tanaka+R&cauthor_id=42687843), [Hiroki Itoh](https://pubmed.ncbi.nlm.nih.gov/?term=Itoh+H&cauthor_id=42687843), [Ryuji Ikeda](https://pubmed.ncbi.nlm.nih.gov/?term=Ikeda+R&cauthor_id=42687843) * PMID: **42687843** * DOI: [ 10.5414/CP205029 ](https://doi.org/10.5414/cp205029) Item in Clipboard # Practical antimicrobial TDM (PAT) of vancomycin in Japanese emergency and critical care units: Concentration overestimation and correction using scaling factors Koki Takeda et al. Int J Clin Pharmacol Ther. 2026. Show details Display options Display options Format Abstract PubMed PMID Int J Clin Pharmacol Ther Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Int+J+Clin+Pharmacol+Ther%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Int+J+Clin+Pharmacol+Ther%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42687843/) . 2026 Sep 3. doi: 10.5414/CP205029. Online ahead of print. ### Authors [Koki Takeda](https://pubmed.ncbi.nlm.nih.gov/?term=Takeda+K&cauthor_id=42687843), [Naoki Yoshikawa](https://pubmed.ncbi.nlm.nih.gov/?term=Yoshikawa+N&cauthor_id=42687843), [Hidehiko Koreeda](https://pubmed.ncbi.nlm.nih.gov/?term=Koreeda+H&cauthor_id=42687843), [Shuhei Urata](https://pubmed.ncbi.nlm.nih.gov/?term=Urata+S&cauthor_id=42687843), [Yuki Matsusaki](https://pubmed.ncbi.nlm.nih.gov/?term=Matsusaki+Y&cauthor_id=42687843), [Tsubasa Yokota](https://pubmed.ncbi.nlm.nih.gov/?term=Yokota+T&cauthor_id=42687843), [Akira Okada](https://pubmed.ncbi.nlm.nih.gov/?term=Okada+A&cauthor_id=42687843), [Ayane Higuchi](https://pubmed.ncbi.nlm.nih.gov/?term=Higuchi+A&cauthor_id=42687843), [Rin Taguchi](https://pubmed.ncbi.nlm.nih.gov/?term=Taguchi+R&cauthor_id=42687843), [Asako Nishimura](https://pubmed.ncbi.nlm.nih.gov/?term=Nishimura+A&cauthor_id=42687843), [Nobuhito Shibata](https://pubmed.ncbi.nlm.nih.gov/?term=Shibata+N&cauthor_id=42687843), [Ryota Tanaka](https://pubmed.ncbi.nlm.nih.gov/?term=Tanaka+R&cauthor_id=42687843), [Hiroki Itoh](https://pubmed.ncbi.nlm.nih.gov/?term=Itoh+H&cauthor_id=42687843), [Ryuji Ikeda](https://pubmed.ncbi.nlm.nih.gov/?term=Ikeda+R&cauthor_id=42687843) * PMID: **42687843** * DOI: [ 10.5414/CP205029 ](https://doi.org/10.5414/cp205029) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Objectives:** i) To improve the accuracy of initial dosing design in vancomycin therapeutic drug monitoring (TDM) using a free web application of practical antimicrobial TDM (PAT) for vancomycin, ii) to identify patient subgroups in emergency and critical care settings with overestimated predicted population mean serum vancomycin concentrations (PRED), and iii) to calculate appropriate PRED scaling factors. **Materials and methods:** Vancomycin serum concentrations in patients treated at the Emergency and Critical Care Centers of the University of Miyazaki Hospital, Japan, were simulated using a population pharmacokinetic model. Patients were classified based on the ratio of observed-to-predicted serum vancomycin concentrations (OBS/PRED). Those with a ratio 15 mL/min, reducing the RMSE from 5.1 to 4.0 (μg/mL). **Conclusion:** PRED scaling factors were derived to potentially improve the accuracy of initial vancomycin dosing using PAT, and ΔCCR > 15 mL/min, ΔALB < -0.5 g/dL, and trauma were identified as key factors. 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