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Vancomycin AUC

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https://www.readbyqxmd.com/read/28807910/24-hour-pharmacokinetic-relationships-for-vancomycin-and-novel-urinary-biomarkers-of-acute-kidney-injury
#1
J Nicholas O'Donnell, Nathaniel J Rhodes, Thomas P Lodise, Walter C Prozialeck, Cristina M Miglis, Medha Joshi, Natarajan Venkatesan, Gwendolyn Pais, Cameron Cluff, Peter C Lamar, Seema Briyal, John Z Day, Anil Gulati, Marc H Scheetz
Introduction: 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 has not been defined. We sought to determine pharmacokinetic/pharmacodynamics indices associated with the development of acute kidney injury using sensitive urinary biomarkers.Methods: Male Sprague-Dawley rats received clinical grade vancomycin or normal saline as an intraperitoneal injection. Total daily doses between 0 and 400 mg/kg/day were administered as single or 2 divided doses over a 24-hour period...
August 14, 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
#2
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
#3
Robert W Seabury, Andrew M Stoessel, Jeffrey M Steele
No abstract text is available yet for this article.
June 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28595277/genetic-alterations-responsible-for-reduced-susceptibility-to-vancomycin-in-community-associated-mrsa-strains-of-st72
#4
Jin Yang Baek, Doo Ryeon Chung, Kwan Soo Ko, So Hyun Kim, Soo-Jin Yang, Cheol-In Kang, Kyong Ran Peck, Jae-Hoon Song
Objectives: We previously reported the first case of vancomycin treatment failure due to development of vancomycin-intermediate resistance in a patient with an MRSA of ST72, a community genotype in Korea. We investigated two isogenic MRSA strains from this patient, who experienced treatment failure with vancomycin and rifampicin. Methods: We tracked the genetic alterations that confer reduced susceptibility to vancomycin on those two isogenic MRSA strains by WGS...
June 7, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28416551/comparative-pharmacodynamics-of-telavancin-and-vancomycin-in-the-neutropenic-murine-thigh-and-lung-infection-models-against-staphylococcus-aureus
#5
Alexander J Lepak, Miao Zhao, David R Andes
The pharmacodynamics of telavancin and vancomycin were compared using neutropenic murine thigh and lung infection models. Four Staphylococcus aureus strains were included. The telavancin MIC ranged from 0.06 to 0.25 mg/liter, and the vancomycin MIC ranged from 1 to 4 mg/liter. The plasma pharmacokinetics of escalating doses (1.25, 5, 20, and 80 mg/kg of body weight) of telavancin and vancomycin were linear over the dose range. Epithelial lining fluid (ELF) pharmacokinetics for each drug revealed that penetration into the ELF mirrored the percentage of the free fraction (the fraction not protein bound) in plasma for each drug...
July 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28373187/auc-mic-pharmacodynamic-target-is-not-a-good-predictor-of-vancomycin-efficacy-in-methicillin-resistant-staphylococcus-aureus-experimental-endocarditis
#6
Ximena Castañeda, Cristina García-de-la-Mària, Oriol Gasch, Juan M Pericas, Yolanda Armero, Dolors Soy, Javier García-González, Carlos Falces, Salvador Ninot, Manel Almela, Juan Ambrosioni, Eduardo Quintana, Barbara Vidal, David Fuster, Jaume Llopis, Sara Soto, Asuncion Moreno, Francesc Marco, Jose M Miró
The aim of this in vivo study was to compare the efficacy of vancomycin at standard doses (VAN-SD) to that of VAN at adjusted doses (VAN-AD) in achieving a VAN area under the curve/MIC ratio (AUC/MIC) of ≥400 against three methicillin-resistant Staphylococcus aureus (MRSA) strains with different microdilution VAN MICs in an experimental endocarditis model. The valve vegetation bacterial counts after 48 h of VAN therapy were compared, and no differences were observed between the two treatment groups for any of the three strains tested...
June 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28337080/vancomycin-auc-mic-and-corresponding-troughs-in-a-pediatric-population
#7
Omayma A Kishk, Allison B Lardieri, Emily L Heil, Jill A Morgan
OBJECTIVES: Adult guidelines suggest an area under the curve/minimum inhibitory concentration (AUC/MIC) > 400 corresponds to a vancomycin trough serum concentration of 15 to 20 mg/L for methicillin-resistant Staphylococcus aureus infections, but obtaining these troughs in children are difficult. The primary objective of this study was to assess the likelihood that 15 mg/kg of vancomycin every 6 hours in a child achieves an AUC/MIC > 400. METHODS: This retrospective chart review included pediatric patients >2 months to <18 years with a positive S aureus blood culture and documented MIC who received at least two doses of vancomycin with corresponding trough...
January 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
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/28250264/methicillin-susceptible-teicoplanin-resistant-staphylococcus-haemolyticus-from-bloodstream-infection-novel-mutation-in-teicoplanin-resistant-operon-tcarab
#9
Yamuna Devi Bakthavatchalam, Thambu David Sudarsanam, Priyanka Babu, Elakkiya Munuswamy, Dhiviya Prabaa Muthuirulandi Sethuvel, Naveen Kumar Devanga Ragupathi, Balaji Veeraraghavan
Staphylococcus haemolyticus is the frequently isolated coagulase-negative staphylococci (CoNS) from blood culture. Here we port a case of methicillin-susceptible S. haemolyticus resistant to teicoplanin and heteroresistant to vancomycin. The isolate was found to susceptible to cefoxitin and resistant to teicoplanin in E-test. PAP-AUC analysis confirmed the presence of vancomycin heteroresistant subpopulation. NGS analysis of the genome revealed the presence of blaZ, msr(A) codes for cross-resistance of macrolide, lincosamide and streptogramin B and quinolone resistance encoding norA gene...
February 28, 2017: Japanese Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28139739/combination-of-cephalosporins-with-vancomycin-or-teicoplanin-enhances-antibacterial-effect-of-glycopeptides-against-heterogeneous-vancomycin-intermediate-staphylococcus-aureus-hvisa-and-visa
#10
Chih-Cheng Lai, Chi-Chung Chen, Yin-Ching Chuang, Hung-Jen Tang
Eight heterogeneous vancomycin-intermediate S. aureus (h-VISA) and seven VISA clinical isolates confirmed by the population analysis profile/area under the curve ratio (PAP/AUC) were collected. We further performed the PAP/AUC, time-killing methods and MIC tests using vancomycin/teicoplanin alone or combination with susceptible breakpoint concentrations of cefazolin, cefmetazole, cefotaxime, and cefepime for these isolates. The PAP/AUC MIC curve shifted left after addition of cephalosporins with vancomycin or teicoplanin for both h-VISA and VISA isolates...
January 31, 2017: Scientific Reports
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/28089661/studying-the-influence-of-formulation-and-process-variables-on-vancomycin-loaded-polymeric-nanoparticles-as-potential-carrier-for-enhanced-ophthalmic-delivery
#12
Carol Yousry, Seham A Elkheshen, Hanan M El-Laithy, Tamer Essam, Rania H Fahmy
Ocular topically applied Vancomycin (VCM) suffers poor bioavailability due to its high molecular weight and hydrophilicity. In the present investigation, VCM-loaded polymeric nanoparticles (PNPs) were developed aiming to enhance its ocular bioavailability through prolonging its release pattern and ophthalmic residence. PNPs were prepared utilizing double emulsion (W/O/O), solvent evaporation technique. 2(3)×4(1) full factorial design was applied to evaluate individual and combined influences of polymer type, Eudragit® RS100, sonication time, and Span®80 concentration on PNPs particle size, encapsulation efficiency, and zeta potential...
March 30, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28017667/assessment-of-optimal-initial-dosing-regimen-with-vancomycin-pharmacokinetics-model-in-very-low-birth-weight-neonates
#13
Hideo Kato, Mao Hagihara, Naoya Nishiyama, Yusuke Koizumi, Hiroshige Mikamo, Katsuhiko Matsuura, Yuka Yamagishi
INTRODUCTION: Pharmacokinetic of vancomycin in very low birth weight neonates showed big variety, and limited data were available due to very minor population. These facts make it difficult to adjust its optimal initial dosage. Therefore, this study was to develop optimal dosing regimen of vancomycin in very low birth weight neonates. METHODS: Between 2010 and 2015, low birth weight neonates (≤1500 g) were included in a population pharmacokinetics analysis. Based on the pharmacokinetic parameters we estimated, we simulated individual blood concentrations of vancomycin and evaluated the probability of its pharmacokinetics/pharmacodynamics (PK/PD) target attainment, such as 24-h area under the concentration-time curve (AUC24)/MIC (≥400) and blood trough concentration (10-20 μg/mL), as primary measure for several dosing regimens by Monte Carlo simulation method...
March 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/27999035/impact-of-vancomycin-protein-binding-on-target-attainment-in-critically-ill-children-back-to-the-drawing-board
#14
Pieter A J G De Cock, Sarah Desmet, Annick De Jaeger, Dominique Biarent, Evelyn Dhont, Ingrid Herck, Daphné Vens, Sofie Colman, Veronique Stove, Sabrina Commeyne, Johan Vande Walle, Peter De Paepe
Objectives: The objectives of this observational study were to investigate plasma protein binding and to evaluate target attainment rates of vancomycin therapy in critically ill children. Patients and methods: Paediatric ICU patients, in whom intravenous intermittent dosing (ID) or continuous dosing (CD) with vancomycin was indicated, were included. Covariates on unbound vancomycin fraction and concentration were tested using a linear mixed model analysis and attainment of currently used pharmacokinetic/pharmacodynamic (PK/PD) targets was evaluated...
March 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27931193/coagulase-negative-staphylococcal-sepsis-in-neonates-do-we-need-to-adapt-vancomycin-dose-or-target
#15
Helgi Padari, Kersti Oselin, Tõnis Tasa, Tuuli Metsvaht, Krista Lõivukene, Irja Lutsar
BACKGROUND: Despite differences in types of infection and causative organisms, pharmacokinetic-pharmacodynamic (PKPD) targets of vancomycin therapy derived from adult studies are suggested for neonates. We aimed to identify doses needed for the attainment of AUC/MIC > 400 and AUC/MIC > 300 in neonates with sepsis and correlate these targets with recommended doses and treatment outcome. METHODS: Neonates who had Vancomycin therapeutic drug monitoring (TDM) performed between January 1, 2010 and December 31, 2012 were studied...
December 8, 2016: BMC Pediatrics
https://www.readbyqxmd.com/read/27861313/is-trough-concentration-of-vancomycin-predictive-of-the-area-under-the-curve-a-clinical-study-in-elderly-patients
#16
Anis Bel Kamel, Laurent Bourguignon, Micaela Marcos, Michel Ducher, Sylvain Goutelle
BACKGROUND: Current guidelines suggest that vancomycin trough concentrations (Cmin) between 15 and 20 mg/L should be achieved to optimize vancomycin exposure and effect. The objective of this study was to analyze the correlation between vancomycin Cmin and the area under the concentration-time curve (AUC) and assess the ability to predict an AUC target of 400 mg·h/L based on Cmin. METHODS: A retrospective analysis of vancomycin therapeutic drug monitoring data collected in 95 elderly patients treated with intermittent intravenous vancomycin was performed...
February 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/27789965/pharmacist-managed-dose-adjustment-feedback-using-therapeutic-drug-monitoring-of-vancomycin-was-useful-for-patients-with-methicillin-resistant-staphylococcus-aureus-infections-a-single-institution-experience
#17
Ryuichi Hirano, Yuichi Sakamoto, Junichi Kitazawa, Shoji Yamamoto, Naoki Tachibana
BACKGROUND: Vancomycin (VCM) requires dose adjustment based on therapeutic drug monitoring. At Aomori Prefectural Central Hospital, physicians carried out VCM therapeutic drug monitoring based on their experience, because pharmacists did not participate in the dose adjustment. We evaluated the impact of an Antimicrobial Stewardship Program (ASP) on attaining target VCM trough concentrations and pharmacokinetics (PK)/pharmacodynamics (PD) parameters in patients with methicillin-resistant Staphylococcus aureus (MRSA) infections...
2016: Infection and Drug Resistance
https://www.readbyqxmd.com/read/27778050/-pharmacokinetics-and-pharmacodynamics-of-antibiotics-in-intensive-care
#18
REVIEW
F Sörgel, R Höhl, R Glaser, C Stelzer, M Munz, M Vormittag, M Kinzig, J Bulitta, C Landersdorfer, A Junger, M Christ, M Wilhelm, U Holzgrabe
Optimized dosage regimens of antibiotics have remained obscure since their introduction. During the last two decades pharmacokinetic(PK)-pharmacodynamic(PD) relationships, originally established in animal experiments, have been increasingly used in patients. The action of betalactams is believed to be governed by the time the plasma concentration is above the minimum inhibitory concentration (MIC). Aminoglycosides act as planned when the peak concentration is a multiple of the MIC and vancomycin seems to work best when the area under the plasma vs...
February 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/27690120/discrepancy-in-vancomycin-auc-mic-ratio-targeted-attainment-based-upon-the-susceptibility-testing-in-staphylococcus-aureus
#19
Seenae Eum, Robert L Bergsbaken, Craig L Harvey, J Bryan Warren, John C Rotschafer
This study demonstrated a statistically significant difference in vancomycin minimum inhibitory concentration (MIC) for Staphylococcus aureus between a common automated system (Vitek 2) and the E-test method in patients with S. aureus bloodstream infections. At an area under the serum concentration time curve (AUC) threshold of 400 mg∙h/L, we would have reached the current Infectious Diseases Society of America (IDSA)/American Society of Health System Pharmacists (ASHP)/Society of Infectious Diseases Pharmacists (SIDP) guideline suggested AUC/MIC target in almost 100% of patients while using the Vitek 2 MIC data; however, we could only generate 40% target attainment while using E-test MIC data (p < 0...
September 27, 2016: Antibiotics
https://www.readbyqxmd.com/read/27401579/molecular-epidemiology-of-a-vancomycin-intermediate-heteroresistant-staphylococcus-epidermidis-outbreak-in-a-neonatal-intensive-care-unit
#20
Jasmine Chong, Caroline Quach, Ana C Blanchard, Philippe Guillaume Poliquin, George R Golding, Céline Laferrière, Simon Lévesque
Coagulase-negative staphylococci (CoNS) have become the leading cause of bloodstream infections (BSIs) in intensive care units (ICUs), particularly in premature neonates. Vancomycin-intermediate heteroresistant CoNS (hVICoNS) have been identified as sources of BSIs worldwide, and their potential to emerge as significant pathogens in the neonatal ICU (NICU) remains uncertain. This study describes the molecular epidemiology of an outbreak of vancomycin-heteroresistant (hV) Staphylococcus epidermidis central-line-associated BSI (CLABSI) in a single tertiary care NICU and compares it to a second tertiary care NICU that had not been associated with an outbreak...
October 2016: Antimicrobial Agents and Chemotherapy
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