Vancomycin is an antibiotic effective against gram-positive bacteria. Due to its narrow therapeutic margin and high inter-subject variability, dose adjustments should be guided by blood concentrations rather than standard dosing regimens. This scoping review aims to synthesize the most recent pharmacokinetic models and identify statistically significant covariates. A literature search of PUBMED and EMBASE databases was conducted from January 2020 to July 2023 for pharmacokinetic models in adults. Twenty-two models were collected, including 12 involving critical care unit patients. The populations studied were highly heterogeneous, including those undergoing continuous renal replacement therapy (CRRT), pregnant women, and patients with augmented renal clearance (ARC). Vancomycin clearance ranged from 1.19 to 7.64 L/h, and the volume of distribution ranged from 22.6 to 122 L. The between-subject variability was considerable, ranging from 7% to 67.7% for clearance and 12.4% to 112% for volume of distribution. Creatinine clearance (ClCr) was a significant covariate in 80% of the models, and weight was significant in 45%. Other covariates such as age, sex, serum creatinine, serum urea, and hospital admission unit were also identified. In conclusion, the development of vancomycin pharmacokinetic models is ongoing due to the diverse population groups with different characteristics requiring specific models. Larger patient cohorts from specific populations are needed to improve model robustness. The reviewed models included patient populations ranging from small cohorts (n=16) to larger groups (n=374), underscoring the need for broader studies.
