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Vancomycin AUC

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https://www.readbyqxmd.com/read/29742643/pharmacokinetic-monitoring-of-vancomycin-in-cystic-fibrosis-is-it-time-to-move-past-trough-concentrations
#1
Nicholas M Fusco, William A Prescott, Calvin J Meaney
BACKGROUND: A correlation between vancomycin trough concentrations (VTC) and area under the curve (AUC) to minimum inhibitory concentration (MIC) ratio (AUC/MIC) has not been established in children/adolescents with cystic fibrosis (CF). The primary objective of this study was to determine the correlation between measured VTCs and AUC/MIC using population-based pharmacokinetics. METHODS: A retrospective cohort study of children/adolescents diagnosed with CF, age 6 to < 18 years, treated with vancomycin (VAN) for methicillin-resistant Staphylococcus aureus (MRSA) infection was conducted...
May 4, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29651827/influence-of-pharmacokinetic-pharmacodynamic-ratio-on-vancomycin-treatment-response-in-paediatric-patients-with-staphylococcus-aureus-bacteremia
#2
Jesus Ruiz, Ana García-Robles, María R Marqués, Maria J Company, Antonio Solana, Jose L Poveda
BACKGROUND: Staphylococcus aureus is a frequent cause of hospital-acquired bacteremia in paediatrics patients. Vancomycin is the drug of choice for the treatment of methicillin-resistant strains, although treatment failure is frequently observed. Area under the curve (AUC) of plasma concentrations over the minimum inhibitory concentration (MIC) has been proposed as the best index to predict treatment response, although information about its clinical impact on paediatric patients is scarce...
April 12, 2018: Minerva Pediatrica
https://www.readbyqxmd.com/read/29602981/population-pharmacokinetics-of-vancomycin-and-auc-guided-dosing-in-chinese-neonates-and-young-infants
#3
Yewei Chen, Dan Wu, Min Dong, Yiqing Zhu, Jinmiao Lu, Xiaoxia Li, Chao Chen, Zhiping Li
OBJECTIVES: To develop a population pharmacokinetic (PK) model for vancomycin in Chinese neonates and infants less than 2 months of age (young infants) with a wide gestational age range, in order to determine the appropriate dosing regimen for this population. METHODS: We performed a retrospective chart review of patients from the neonatal intensive care unit (NICU) at Children's Hospital of Fudan University to identify neonates and young infants treated with vancomycin from May 2014 to May 2017...
March 30, 2018: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29561305/exploring-the-use-of-c-reactive-protein-to-estimate-the-pharmacodynamics-of-vancomycin
#4
Timothy M Rawson, Esmita Charani, Luke Sp Moore, Mark Gilchrist, Pantelis Georgiou, William Hope, Alison H Holmes
BackgroundC-reactive protein (CRP) pharmacodynamic (PD) models have the potential to provide adjunctive methods for predicting the individual exposure-response to antimicrobial therapy. We investigated CRP PD linked to a vancomycin pharmacokinetics (PK) model using routinely collected data from non-critical care adults in secondary care.MethodsPatients receiving intermittent intravenous vancomycin therapy in secondary care were identified. A two-compartment vancomycin PK model was linked to a previously described PD model describing CRP response...
March 20, 2018: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/29554847/the-impact-of-auc-based-monitoring-on-pharmacist-directed-vancomycin-dose-adjustments-in-complicated-methicillin-resistant-staphylococcus-aureus-infection
#5
Andrew M Stoessel, Cory M Hale, Robert W Seabury, Christopher D Miller, Jeffrey M Steele
OBJECTIVE: This study aimed to assess the impact of area under the curve (AUC)-based vancomycin monitoring on pharmacist-initiated dose adjustments after transitioning from a trough-only to an AUC-based monitoring method at our institution. METHODS: A retrospective cohort study of patients treated with vancomycin for complicated methicillin-resistant Staphylococcus aureus (MRSA) infection between November 2013 and December 2016 was conducted. The frequency of pharmacist-initiated dose adjustments was assessed for patients monitored via trough-only and AUC-based approaches for trough ranges: 10 to 14...
January 1, 2018: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29494420/vancomycin-area-under-the-curve-simplified
#6
Paul Lewis
BACKGROUND: Serum trough concentrations as the sole means of monitoring safety and efficacy of vancomycin are insufficient. The daily area under the curve (AUC24) of serum concentration versus time to minimum inhibitory concentration (MIC) ratio of greater than 400 mg × h/L has emerged as a more robust dosing target. A simple and practical method to extrapolate AUC24 from troughs is needed. METHODS: This mathematical model computes the median and range AUC24 using the dose in mg/kg and the observed serum trough concentration...
June 2018: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/29461449/optimizing-vancomycin-monitoring-in-pediatric-patients
#7
Abdullah Alsultan, Manal Abouelkheir, Saeed Alqahtani, Ahmad Aljabri, Ali M Somily, Sarah Alsubaie, Abdulkarim Alrabiaah, Elham Bukhari, Fahad Alzamil
INTRODUCTION: Several studies have reported that trough levels may not be optimal for monitoring vancomycin therapy, because of overexposure and nephrotoxicity risks. Therefore, we developed a population pharmacokinetic model to optimize vancomycin dosing and monitoring in pediatrics. METHODS: Data were retrospectively collected on 76 pediatric patients aged 1-12 years, admitted to general pediatric wards or ICUs at King Saud University Medical City, Riyadh, Saudi Arabia...
February 15, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29445884/acute-kidney-injury-epidemiology-risk-factors-and-outcomes-in-critically-ill-patients-16-25-years-of-age-treated-in-an-adult-intensive-care-unit
#8
Dana Y Fuhrman, Sandra Kane-Gill, Stuart L Goldstein, Priyanka Priyanka, John A Kellum
BACKGROUND: Most studies of acute kidney injury (AKI) have focused on older adults, and little is known about AKI in young adults (16-25 years) that are cared for in an adult intensive care unit (ICU). We analyzed data from a large single-center ICU database and defined AKI using the Kidney Disease Improving Global Outcomes criteria. We stratified patients 16-55 years of age into four age groups for comparison and used multivariable logistic regression to identify associations of potential susceptibilities and exposures with AKI and mortality...
February 14, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29380499/removal-of-vancomycin-administered-during-dialysis-by-a-high-flux-dialyzer
#9
Heather A Nyman, Adhish Agarwal, Harry O Senekjian, John K Leypoldt, Alfred K Cheung
INTRODUCTION: Hemodialysis patients frequently receive vancomycin for treatment of gram-positive bacterial infections. This drug is most conveniently administered in outpatient dialysis units during the hemodialysis treatment. However, there is a paucity of data on the removal of vancomycin by high-flux polyamide dialyzers. METHODS: This is a prospective crossover study in which seven uninfected chronic hemodialysis patients at three dialysis units received vancomycin 1 gram intravenously over one hour immediately after the dialysis treatment (Phase 1), and vancomycin 1...
January 30, 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29344778/the-relationship-between-vancomycin-trough-concentrations-and-auc-mic-ratios-in-pediatric-patients-a-qualitative-systematic-review
#10
REVIEW
Stacey Tkachuk, Kyle Collins, Mary H H Ensom
BACKGROUND: In adults, the area under the concentration-time curve (AUC) divided by the minimum inhibitory concentration (MIC) is associated with better clinical and bacteriological response to vancomycin in patients with methicillin-resistant Staphylococcus aureus who achieve target AUC/MIC ≥ 400. This target is often extrapolated to pediatric patients despite the lack of similar evidence. The impracticalities of calculating the AUC in practice means vancomycin trough concentrations are used to predict the AUC/MIC...
April 2018: Paediatric Drugs
https://www.readbyqxmd.com/read/29290237/antibiotic-pharmacokinetic-and-pharmacodynamic-parameters-in-pediatric-clinical-practice
#11
R Cohen, E Grimprel
Progress in the knowledge of antibiotic mechanisms of action allows to determine the pharmacodynamics/pharmacokinetic (PK/PD) parameters predictive of antibiotic efficacy in bacterial infections. According to the antibiotic compound, the bacterial species implicated, the location of the infection, and the severity of the disease, these parameters may vary. The PK/PD parameters described in this paper, focus only on blood compartments. These PK/PD parameters best predict efficacy in the most frequent infections (e...
December 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/29284156/vancomycin-dosing-in-chronic-high-flux-haemodialysis-a-systematic-review
#12
Katrina Hui, Lydia Upjohn, Michelle Nalder, Kirsty Buising, Eugenie Pedagogos, Craig Nelson, Carl M J Kirkpatrick, David C M Kong
The aim of this study was to systematically evaluate whether non-weight-based dosing (non-WBD) or weight-based dosing (WBD) of vancomycin leads to a higher proportion of patients achieving the pharmacokinetic/pharmacodynamic target. Studies from January 1985 to February 2017 were identified through Cochrane, MEDLINE and Embase databases. Those conducted in adults with end-stage renal disease receiving high-flux haemodialysis (HD) and intravenous vancomycin were included. The primary outcome was the proportion of patients with a pre-HD vancomycin concentration of 15-20 mg/L and/or an area under the concentration-time curve/minimum inhibitory concentration (AUC/MIC) ratio ≥400...
December 25, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29260505/vancomycin-dosing-and-monitoring-critical-evaluation-of-the-current-practice
#13
Fawzy Elbarbry
After more than six decades of its use as the mainstay antibiotic for the treatment of multidrug-resistant Gram-positive bacterial infections, dosing and monitoring of vancomycin therapy have not been optimized. The current vancomycin therapeutic guidelines recommend empiric doses of 15-20 mg/kg administered by intermittent infusion every 8-12 h in patients with normal kidney function. Additionally, the guidelines recommend trough concentration of 15-20 mg/L as a therapeutic goal for adult patients with severe infections...
December 19, 2017: European Journal of Drug Metabolism and Pharmacokinetics
https://www.readbyqxmd.com/read/29203493/prospective-trial-on-the-use-of-trough-concentration-versus-area-under-the-curve-to-determine-therapeutic-vancomycin-dosing
#14
Michael N Neely, Lauren Kato, Gilmer Youn, Lironn Kraler, David Bayard, Michael van Guilder, Alan Schumitzky, Walter Yamada, Brenda Jones, Emi Minejima
We hypothesized that dosing vancomycin to achieve trough concentrations of >15 mg/liter overdoses many adults compared to area under the concentration-time curve (AUC)-guided dosing. We conducted a 3-year, prospective study of vancomycin dosing, plasma concentrations, and outcomes. In year 1, nonstudy clinicians targeted trough concentrations of 10 to 20 mg/liter (infection dependent) and controlled dosing. In years 2 and 3, the study team controlled vancomycin dosing with BestDose Bayesian software to achieve a daily, steady-state AUC/MIC ratio of ≥400, with a maximum AUC value of 800 mg · h/liter, regardless of trough concentration...
February 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29028077/urinary-kidney-injury-molecule-1-and-neutrophil-gelatinase-associated-lipocalin-as-early-biomarkers-for-predicting-vancomycin-associated-acute-kidney-injury-a-prospective-study
#15
H-M Pang, X-L Qin, T-T Liu, W-X Wei, D-H Cheng, H Lu, Q Guo, L Jing
OBJECTIVE: Previous studies have demonstrated that urinary kidney injury molecule-1 (uKIM-1) and neutrophil gelatinase-associated lipocalin (uNGAL) were superior to serum creatinine (Scr) in detecting acute kidney injury (AKI), but their ability to predict clinical vancomycin-associated AKI has not been investigated. This study aimed to investigate the abilities of uKIM-1 and uNGAL individually and in combination to predict vancomycin-associated AKI. PATIENTS AND METHODS: Scr, uKIM-1, and uNGAL were measured on the day before and days 1, 2, and 3 of vancomycin therapy in a generalized adult population...
September 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28923869/a-quasi-experiment-to-study-the-impact-of-vancomycin-area-under-the-concentration-time-curve-guided-dosing-on-vancomycin-associated-nephrotoxicity
#16
Natalie A Finch, Evan J Zasowski, Kyle P Murray, Ryan P Mynatt, Jing J Zhao, Raymond Yost, Jason M Pogue, Michael J Rybak
Evidence suggests that maintenance of vancomycin trough concentrations at between 15 and 20 mg/liter, as currently recommended, is frequently unnecessary to achieve the daily area under the concentration-time curve (AUC24 ) target of ≥400 mg · h/liter. Many patients with trough concentrations in this range have AUC24 values in excess of the therapeutic threshold and within the exposure range associated with nephrotoxicity. On the basis of this, the Detroit Medical Center switched from trough concentration-guided dosing to AUC-guided dosing to minimize potentially unnecessary vancomycin exposure...
December 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28903517/association-of-vancomycin-trough-concentration-with-response-to-treatment-for-acute-pulmonary-exacerbation-of-cystic-fibrosis
#17
Nicholas M Fusco, Richard Francisconi, Calvin J Meaney, Desiree Duman, Carla A Frederick, William A Prescott
Background: Our goal was to determine the relationship between serum vancomycin trough concentrations (VTCs) and changes in pulmonary function among individuals with an acute pulmonary exacerbation (APE) of cystic fibrosis (CF). Methods: We included subjects who were ≥6 years of age, were hospitalized for an APE of CF between May 1, 2012, and April 30, 2014, were administered vancomycin for ≥48 hours, and had a history of airway infection with methicillin-resistant Staphylococcus aureus...
September 1, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28807910/24-hour-pharmacokinetic-relationships-for-vancomycin-and-novel-urinary-biomarkers-of-acute-kidney-injury
#18
J Nicholas O'Donnell, Nathaniel J Rhodes, Thomas P Lodise, Walter C Prozialeck, Cristina M Miglis, Medha D Joshi, Natarajan Venkatesan, Gwendolyn Pais, Cameron Cluff, Peter C Lamar, Seema Briyal, John Z Day, Anil Gulati, Marc H Scheetz
Vancomycin has been associated with acute kidney injury in preclinical and clinical settings; however, the precise exposure profiles associated with vancomycin-induced acute kidney injury have not been defined. We sought to determine pharmacokinetic/pharmacodynamics indices associated with the development of acute kidney injury using sensitive urinary biomarkers. Male Sprague-Dawley rats received clinical-grade vancomycin or normal saline as an intraperitoneal injection. Total daily doses between 0 and 400 mg/kg of body weight were administered as a single dose or 2 divided doses over a 24-h period...
November 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28764660/relationship-between-day-1-and-day-2-vancomycin-area-under-the-curve-values-and-emergence-of-heterogeneous-vancomycin-intermediate-staphylococcus-aureus-hvisa-by-etest%C3%A2-macromethod-among-patients-with-mrsa-bloodstream-infections-a-pilot-study
#19
Dmitriy M Martirosov, Monique R Bidell, Manjunath P Pai, Marc H Scheetz, Susan L Rosenkranz, Corey Faragon, M Malik, R E Mendes, R N Jones, Louise-Anne McNutt, Thomas P Lodise
BACKGROUND: In vitro data suggests that suboptimal initial vancomycin exposure may select for heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA) infections. However, no clinical studies have evaluated the relationship between initial vancomycin exposure and emergence of hVISA. This pilot study seeks to assess the relationship between day 1 and day 2 vancomycin area under the curve (AUC) and emergence of hVISA bloodstream infections (BSIs) by Etest® macromethod among patients with a non-hVISA BSI at baseline...
August 2, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28627271/vancomycin-trough-concentration-poorly-characterizes-auc-is-it-time-to-transition-to-auc-based-vancomycin-monitoring
#20
Robert W Seabury, Andrew M Stoessel, Jeffrey M Steele
No abstract text is available yet for this article.
October 2017: Annals of Pharmacotherapy
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