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Vancomycin AUC

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https://www.readbyqxmd.com/read/29290237/antibiotic-pharmacokinetic-and-pharmacodynamic-parameters-in-pediatric-clinical-practice
#1
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
#2
Katrina Hui, Lydia Upjohn, Michelle Nalder, Kirsty Buising, Eugenie Pedagogos, Craig Nelson, Carl M J Kirkpatrick, David C M Kong
OBJECTIVES: This study aimed to systematically evaluate if non-weight-based (non-WBD) or weight-based dosing (WBD) of vancomycin led to a higher proportion of patients achieving the pharmacokinetic/pharmacodynamic target. METHODS: 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 and intravenous vancomycin were included...
December 25, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29260505/vancomycin-dosing-and-monitoring-critical-evaluation-of-the-current-practice
#3
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/a-prospective-trial-on-the-use-of-trough-concentration-versus-area-under-the-curve-auc-to-determine-therapeutic-vancomycin-dosing
#4
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 >15 mg/L overdoses many adults compared to AUC-guided dosing. We conducted a 3-year, prospective study of vancomycin dosing, plasma concentrations, and outcomes. In year 1, non-study clinicians targeted trough concentrations of 10-20 mg/L (infection dependent) and controlled dosing. In years 2 and 3, the study team controlled vancomycin dosing with the BestDose Bayesian software to achieve a daily, steady-state AUC:MIC≥400, with maximum AUC 800 mg*h/L, regardless of trough concentration...
December 4, 2017: 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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
Robert W Seabury, Andrew M Stoessel, Jeffrey M Steele
No abstract text is available yet for this article.
October 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
#11
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...
September 1, 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
#12
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
#13
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
#14
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
#15
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-isolate-from-a-bloodstream-infection-with-novel-mutations-in-the-tcarab-teicoplanin-resistance-operon
#16
Yamuna Devi Bakthavatchalam, Thambu David Sudarsanam, Priyanka Babu, Elakkiya Munuswamy, Dhiviya Prabaa Muthuirulandi Sethuvel, Naveen Kumar Devanga Ragupathi, Balaji Veeraraghavan
Staphylococcus haemolyticus is a coagulase-negative staphylococcus that is frequently isolated from blood cultures. Here, we report a case of methicillin-susceptible S. haemolyticus that is resistant to teicoplanin (TEC) and heteroresistant to vancomycin (VAN). The isolate was susceptible to cefoxitin and resistant to TEC by Etest. Population analysis profile-area under the curve analysis confirmed the presence of a VAN heteroresistant subpopulation. Next-generation sequencing analysis of the genome revealed the presence of blaZ and msr(A), which encode cross-resistance to macrolide, lincosamide, and streptogramin B, and the quinolone resistance-conferring gene norA...
July 24, 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
#17
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
#18
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
#19
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
#20
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
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