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https://www.readbyqxmd.com/read/28815425/methodological-study-of-vancomycin-dosing-in-elderly-patients-using-actual-serum-creatinine-versus-rounded-serum-creatinine
#1
Tramaine Young, Matt Daniel, Stephanie Baumhover, Duke Eidson, Jane Green
PURPOSE: The practice of intentional rounding up of serum creatinine (SCr) in elderly patients with low measured values can lead to an underestimation of creatinine clearance and subsequent inaccurate dosing of medications. Thus, the purpose of this study was to evaluate the accuracy of vancomycin dose calculations for patients aged ≥65 years using an SCr rounded up to 1 mg/dL versus actual SCr. METHODS: This study compared the difference between measured steady-state vancomycin trough concentrations with predicted trough concentrations that have been calculated using rounded SCr and actual SCr...
August 16, 2017: Drugs in R&D
https://www.readbyqxmd.com/read/28807918/relationships-of-vancomycin-pharmacokinetics-to-body-size-and-composition-by-computed-tomography-analysis-a-novel-pharmacomorphomic-approach
#2
Manjunath P Pai, Brian A Derstine, Matt Lichty, Brian E Ross, June Sullivan, Grace L Su, Stewart C Wang
Antibiotics such as vancomycin are empirically dosed on body weight, which may not be optimal across the expanding adult body size distribution. Our aim was to compare the relationships between morphomic parameters generated from computed tomography images to conventional body size metrics as predictors of vancomycin pharmacokinetics (PK). This single center retrospective study included 300 patients with 1622 vancomycin concentration (52% trough) measurements. Bayesian estimation was used to compute individual vancomycin volume of distribution of the central compartment (Vc) and clearance (CL)...
August 14, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28709394/intravenous-vancomycin-is-associated-with-the-development-of-nephrotoxicity-in-patients-with-class-iii-obesity
#3
Yookyung Christy Choi, Stephen Saw, Daniel Soliman, Angela L Bingham, Laura Pontiggia, Krystal Hunter, Linda Chuang, Laura A Siemianowski, Benjamin Ereshefsky, James M Hollands
BACKGROUND: A consensus statement recommends initial intravenous (IV) vancomycin dosing of 15-20 mg/kg every 8- 24 hours, with an optional 25- to 30-mg/kg loading dose. Although some studies have shown an association between weight and the development of vancomycin-associated nephrotoxicity, results have been inconsistent. OBJECTIVE: To evaluate the correlation between incidence of nephrotoxicity associated with weight-based IV vancomycin dosing strategies in nonobese and obese patients...
July 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28699136/intrawound-application-of-vancomycin-changes-the-responsible-germ-in-elective-spine-surgery-without-significant-effect-on-the-rate-of-infection-a-randomized-prospective-study
#4
B Mirzashahi, M Chehrassan, S M J Mortazavi
PURPOSE: Surgical site infection (SSI) is a costly complication associated with spine surgery. The impact of intrawound vancomycin has not been strongly postulated to decrease the risk of surgical site infection. We designed study to determine whether intrawound vancomycin application reduces the risk of SSI in patients after spine surgery. METHODS: A prospective randomized control trial study to evaluate the patients with elective spine surgery in a period of 15 month was designed...
July 11, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28647339/the-effects-of-amoxicillin-and-vancomycin-on-parameters-reflecting-cholesterol-metabolism
#5
S Baumgartner, D Reijnders, M C J M Konings, A K Groen, D Lütjohann, G H Goossens, E E Blaak, J Plat
BACKGROUND: Changes in the microbiota composition have been implicated in the development of obesity and type 2 diabetes. However, not much is known on the involvement of gut microbiota in lipid and cholesterol metabolism. In addition, the gut microbiota might also be a potential source of plasma oxyphytosterol and oxycholesterol concentrations (oxidation products of plant sterols and cholesterol). Therefore, the aim of this study was to modulate the gut microbiota by antibiotic therapy to investigate effects on parameters reflecting cholesterol metabolism and oxyphytosterol concentrations...
June 21, 2017: Chemistry and Physics of Lipids
https://www.readbyqxmd.com/read/28560172/a-case-of-osteomyelitis-of-the-toe-caused-by-coccidioidomycosis-in-a-17-year-old-with-diabetes-insipidus
#6
Ahmer Khalid, Daniel J Boken, Christine A Nelson, Vicken Y Totten
We report a case of a 17-year-old male who presented with pain in his right first toe. His pain and swelling had worsened and x-rays of his foot revealed erosive changes of the great toe distal phalanx suggesting possible osteomyelitis. His co-morbidities were morbid obesity and diabetes insipidus. He was admitted to the hospital, blood cultures were drawn, and he was started on vancomycin for presumed bacterial osteomyelitis. He underwent incision and drainage of the fluctuant abscess of the toe, where a culture of the wound was taken...
2017: IDCases
https://www.readbyqxmd.com/read/28522643/allometric-versus-consensus-guideline-dosing-in-achieving-target-vancomycin-trough-concentrations
#7
Matthew L Brown, Amber M Hutchison, Aaron M McAtee, Philippe R Gaillard, Darrell T Childress
PURPOSE: Results of a study comparing the performance of allometric versus consensus guideline-recommended vancomycin dosing in achieving initial trough concentrations within the desired range are reported. METHODS: A retrospective study was conducted to compare selected outcomes with 2 vancomycin dosing methods: (1) dosing by total body weight, as recommended in current consensus guidelines, and (2) a new empirical vancomycin dosing strategy grounded in allometry (the study of the relationship between body size and physiology)...
July 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28289024/pilot-study-of-a-bayesian-approach-to-estimate-vancomycin-exposure-in-obese-patients-with-limited-pharmacokinetic-sampling
#8
Joseph J Carreno, Ben Lomaestro, John Tietjan, Thomas P Lodise
This study evaluated the predictive performance of a Bayesian PK estimation method (ADAPT V) to estimate the 24-h vancomycin area under the curve (AUC) with limited pharmacokinetic (PK) sampling in adult obese patients receiving vancomycin for suspected or confirmed Gram-positive infections. This was an Albany Medical Center Institutional Review Board-approved prospective evaluation of 12 patients. Patients had a median (95% confidence interval) age of 61 years (39 to 71 years), a median creatinine clearance of 86 ml/min (75 to 120 ml/min), and a median body mass index of 45 kg/m(2) (40 to 52 kg/m(2))...
May 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28235986/-fecal-microbiota-transplantation
#9
C Lübbert, B Salzberger, J Mössner
The human intestinal microbiome has important metabolic and immunological functions for the host and is part of the defense against pathogens in the gastrointestinal tract. Antibiotics, probiotics, dietary measures, such as prebiotics, and the relatively newly established method of fecal microbiota transplantation (FMT, also known as fecal microbiome transfer) all influence the intestinal microbiome. The FMT procedure comprises the transmission of fecal microorganisms from a healthy donor into the gastrointestinal tract of a patient...
February 24, 2017: Der Internist
https://www.readbyqxmd.com/read/28118218/obesity-and-skin-and-soft-tissue-infections-how-to-optimize-antimicrobial-usage-for-prevention-and-treatment
#10
Mordechai Grupper, David P Nicolau
PURPOSE OF REVIEW: Skin and soft tissue infections (SSTIs) are prevalent in the obese population, with rising trend expected. Although numerous antibiotics are available for the prevention and treatment of SSTIs, their characterization in obese patients is not a regulatory mandate. Consequently, information that carries importance for optimizing the dosing regimen in the obese population may not be readily available. This review focuses on the most recent pharmacokinetic and pharmacodynamic data on this topic with attention to cefazolin for surgical prophylaxis as well as antibiotics that are active against methicillin-resistant Staphylococcus aureus (MRSA)...
April 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28096158/peak-measurement-for-vancomycin-auc-estimation-in-obese-adults-improves-precision-and-lowers-bias
#11
Manjunath P Pai, Joseph Hong, Lynne Krop
Vancomycin area under the curve (AUC) estimates may be skewed in obese adults due to weight-dependent pharmacokinetic parameters. We demonstrate that peak and trough measurements reduce bias and improve the precision of vancomycin AUC estimates in obese adults (n = 75) and validate this in an independent cohort (n = 31). The precision and mean percent bias of Bayesian vancomycin AUC estimates are comparable between covariate-dependent (R(2) = 0.774, 3.55%) and covariate-independent (R(2) = 0.804, 3.28%) models when peaks and troughs are measured but not when measurements are restricted to troughs only (R(2) = 0...
April 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28079262/pediatric-obesity-pharmacokinetic-alterations-and-effects-on-antimicrobial-dosing
#12
REVIEW
Stephanie Natale, John Bradley, William Huy Nguyen, Tri Tran, Pamela Ny, Kirsten La, Eva Vivian, Jennifer Le
Limited data exist for appropriate drug dosing in obese children. This comprehensive review summarizes pharmacokinetic (PK) alterations that occur with age and obesity, and these effects on antimicrobial dosing. A thorough comparison of different measures of body weight and specific antimicrobial agents including cefazolin, cefepime, ceftazidime, daptomycin, doripenem, gentamicin, linezolid, meropenem, piperacillin-tazobactam, tobramycin, vancomycin, and voriconazole is presented. PubMed (1966-July 2015) and Cochrane Library searches were performed using these key terms: children, pharmacokinetic, obesity, overweight, body mass index, ideal body weight, lean body weight, body composition, and specific antimicrobial drugs...
March 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/27920984/staphylococcus-lugdunensis-endocarditis-with-destruction-of-the-ventricular-septum-and-multiple-native-valves
#13
Celestine Ishiekwene, Monica Ghitan, Margaret Kuhn-Basti, Edward Chapnick, Yu Shia Lin
Staphylococcus lugdunensis (S. lugdunensis) is a coagulase negative staphylococcus (CoNS) that can cause destructive infective endocarditis. S. lugdunensis, unlike other CoNS, should be considered to be a pathogen. We report the first case of S. lugdunensis endocarditis causing ventricular septal defect and destruction of the aortic and mitral valves. A 53-year-old male with morbid obesity and COPD presented with intermittent fever and progressive shortness of breath for 2 weeks. Chest examination showed bilateral basal crepitations, and a grade 2 systolic murmur along the right sternal border...
2017: IDCases
https://www.readbyqxmd.com/read/27899248/unexplained-increases-in-serum-vancomycin-concentration-in-a-morbidly-obese-patient
#14
REVIEW
Sean P Kane, Scott D Hanes
INTRODUCTION: To report a case of increases in vancomycin concentrations without additional vancomycin doses being given. CASE STUDY: A 64 year-old morbidly obese female received three total doses of vancomycin for surgical prophylaxis and for ventilator-associated pneumonia. Subsequent vancomycin concentrations from the patient's central venous catheter (CVC) demonstrated increasing drug levels from 27.1 to 45.9mcg/mL despite no additional vancomycin being given and proper line flushing prior to sample collection...
April 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/27788522/vancomycin-trough-and-acute-kidney-injury-a-large-retrospective-cohort-study
#15
Kassem Hammoud, Michael Brimacombe, Alan Yu, Neil Goodloe, Wael Haidar, Wissam El Atrouni
BACKGROUND: The association between vancomycin trough (VT) and acute kidney injury (AKI) at the recommended doses remains controversial. METHODS: The authors conducted a retrospective, observational cohort study of 500 adult patients who received vancomycin for ≥72 h. Data collected included 2 main predictors: average VT (including only VTs before the occurrence of AKI), first VT and other possible risk factors for AKI. The baseline characteristics/variables between patients with AKI and patients with no AKI were compared...
2016: American Journal of Nephrology
https://www.readbyqxmd.com/read/27757973/comparison-of-open-access-vancomycin-dosing-websites
#16
COMPARATIVE STUDY
N P Fewel
WHAT IS KNOWN AND OBJECTIVE: There are many methods for dosing vancomycin. The purpose of this commentary was to compare open-access vancomycin dosing websites with Vancomycin-Calculator.com and describe how body weight can affect their pharmacokinetic (PK) calculations. COMMENT: A vancomycin dosing website, Vancomycin-Calculator.com, was developed to improve the dosing practice at our health system. Nine other vancomycin dosing calculators were identified, including three open-access websites...
April 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/27573067/risk-factors-for-surgical-site-infections-following-adult-spine-operations
#17
Ambar Haleem, Hsiu-Yin Chiang, Ravindhar Vodela, Andrew Behan, Jean M Pottinger, Joseph Smucker, Jeremy D Greenlee, Charles Clark, Loreen A Herwaldt
OBJECTIVE To identify risk factors for surgical site infections (SSIs) after spine operations. DESIGN Case-control study of SSIs among patients undergoing spine operations. SETTING An academic health center. PATIENTS We studied patients undergoing spinal fusions or laminectomies at the University of Iowa Hospitals and Clinics from January 1, 2007, through June 30, 2009. We included patients who acquired SSIs meeting the National Healthcare Safety Network definition. We randomly selected controls among patients who had spine operations during the study period and did not meet the SSI definition...
December 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27538956/information-provision-for-antibacterial-dosing-in-the-obese-patient-a-sizeable-absence
#18
Sara Elizabeth Boyd, Esmita Charani, Tracy Lyons, Gary Frost, Alison Helen Holmes
BACKGROUND: Obesity is on course to overtake being underweight as a global disease burden. Obesity alters antibacterial pharmacokinetics (PK) and pharmacodynamics (PD). Historically, drug PK/PD parameters have not been studied in obese populations. This means dose recommendations risk being sub-therapeutic in a population at increased risk of infection. Suboptimal antibacterial prescribing is widely associated with treatment failure, worse clinical outcomes, unnecessary escalation to broad-spectrum therapy and the emergence of antimicrobial resistance (AMR)...
December 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27503643/effects-of-lipid-lowering-drugs-on-vancomycin-susceptibility-of-mycobacteria
#19
Céline Rens, Françoise Laval, Mamadou Daffé, Olivier Denis, Rosangela Frita, Alain Baulard, Ruddy Wattiez, Philippe Lefèvre, Véronique Fontaine
Tuberculosis is still a cause of major concern, partly due to the emergence of multidrug-resistant strains. New drugs are therefore needed. Vancomycin can target mycobacteria with cell envelope deficiency. In this study, we used a vancomycin susceptibility assay to detect drugs hampering lipid synthesis in Mycobacterium bovis BCG and in Mycobacterium tuberculosis We tested three drugs already used to treat human obesity: tetrahydrolipstatin (THL), simvastatin, and fenofibrate. Only vancomycin and THL were able to synergize on M...
October 2016: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27411009/effects-of-gut-microbiota-manipulation-by-antibiotics-on-host-metabolism-in-obese-humans-a-randomized-double-blind-placebo-controlled-trial
#20
RANDOMIZED CONTROLLED TRIAL
Dorien Reijnders, Gijs H Goossens, Gerben D A Hermes, Evelien P J G Neis, Christina M van der Beek, Jasper Most, Jens J Holst, Kaatje Lenaerts, Ruud S Kootte, Max Nieuwdorp, Albert K Groen, Steven W M Olde Damink, Mark V Boekschoten, Hauke Smidt, Erwin G Zoetendal, Cornelis H C Dejong, Ellen E Blaak
The gut microbiota has been implicated in obesity and cardiometabolic diseases, although evidence in humans is scarce. We investigated how gut microbiota manipulation by antibiotics (7-day administration of amoxicillin, vancomycin, or placebo) affects host metabolism in 57 obese, prediabetic men. Vancomycin, but not amoxicillin, decreased bacterial diversity and reduced Firmicutes involved in short-chain fatty acid and bile acid metabolism, concomitant with altered plasma and/or fecal metabolite concentrations...
July 12, 2016: Cell Metabolism
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