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Vancomycin AUC

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https://www.readbyqxmd.com/read/28096158/vancomycin-area-under-the-curve-estimation-in-obese-adults-the-peak-improves-precision-and-lowers-bias
#1
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 %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 restricted to trough only measurements (R(2),= 0...
January 17, 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
#2
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...
January 12, 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
#3
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...
December 22, 2016: 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
#4
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...
December 20, 2016: 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
#5
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
#6
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 (IV) vancomycin was performed...
November 17, 2016: 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
#7
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
#8
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...
October 24, 2016: 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
#9
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
#10
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
https://www.readbyqxmd.com/read/27291466/auc-guided-vancomycin-dosing-in-adolescent-patients-with-suspected-sepsis
#11
Shankar Lanke, Tian Yu, Joseph E Rower, Alfred H Balch, E Kent Korgenski, Catherine M Sherwin
Vancomycin is a first-line treatment for β-lactam-resistant Gram-positive bacterial infections. Understanding the pharmacokinetic (PK) and pharmacodynamic (PD) characteristics of vancomycin in an adolescent population is of clinical importance in this often overlooked pediatric population. This retrospective study investigated vancomycin PK-PD in an adolescent cohort (12 to 18 years of age) of 463 patients (57% male, 81% white) admitted to the Intermountain Healthcare System between January 2006 and December 2013...
January 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27189121/antibacterial-activity-of-the-novel-semisynthetic-lantibiotic-nvb333-in-vitro-and-in-experimental-infection-models
#12
Steven Boakes, William J Weiss, Mary Vinson, Sjoerd Wadman, Michael J Dawson
NVB333 is a novel semisynthetic lantibiotic derived from the amide coupling of 3,5-dichlorobenzylamine to the C-terminal of deoxyactagardine B. The in vitro activity of NVB333 includes efficacy against clinically relevant pathogens including methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus spp. NVB333 shows no cross-resistance with other antibiotics tested and a very low propensity for resistance development. After intravenous dosing NVB333 has high exposure in mouse plasma and shows generally improved in vivo activity compared with vancomycin in mouse infection models despite modest MIC values...
December 2016: Journal of Antibiotics
https://www.readbyqxmd.com/read/27144370/association-of-the-clinical-efficacy-of-vancomycin-with-the-novel-pharmacokinetic-parameter-area-under-the-trough-level-autl-in-elderly-patients-with-hospital-acquired-pneumonia
#13
S Fukumori, Y Tsuji, A Mizoguchi, H Kasai, T Ishibashi, N Iwamura, H To
WHAT IS KNOWN AND OBJECTIVE: The pharmacokinetic-pharmacodynamic parameter that best predicts the efficacy of vancomycin is the ratio of the area under the concentration versus time curve (AUC) to the minimum inhibitory concentration (MIC). A 24-h AUC (AUC24 )/MIC ratio ≥ 400 was recommended in an American consensus review, but vancomycin treatment occasionally fails despite maintenance of AUC24 /MIC ≥ 400. We evaluated the association between clinical efficacy of vancomycin and two novel pharmacokinetic parameters, the 'area under the trough level' (AUTL) and the 'area above the trough level' (AATL), in hospitalized elderly patients with methicillin-resistant Staphylococcus aureus (MRSA) pneumonia...
August 2016: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/27123458/urinary-3-3-hydroxyphenyl-3-hydroxypropionic-acid-3-hydroxyphenylacetic-acid-and-3-hydroxyhippuric-acid-are-elevated-in-children-with-autism-spectrum-disorders
#14
Xiyue Xiong, Dan Liu, Yichao Wang, Ting Zeng, Ying Peng
Autism spectrum disorders (ASDs) are a group of mental illnesses highly correlated with gut microbiota. Recent studies have shown that some abnormal aromatic metabolites in autism patients are presumably derived from overgrown Clostridium species in gut, which may be used for diagnostic purposes. In this paper, a GC/MS based metabolomic approach was utilized to seek similar biomarkers by analyzing the urinary information in 62 ASDs patients compared with 62 non-ASDs controls in China, aged 1.5-7. Three compounds identified as 3-(3-hydroxyphenyl)-3-hydroxypropionic acid (HPHPA), 3-hydroxyphenylacetic acid (3HPA), and 3-hydroxyhippuric acid (3HHA) were found in higher concentrations in autistic children than in the controls (p < 0...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27074786/are-vancomycin-trough-concentrations-of-15-to-20-mg-l-associated-with-increased-attainment-of-an-auc-mic-%C3%A2-400-in-patients-with-presumed-mrsa-infection
#15
Cory M Hale, Robert W Seabury, Jeffrey M Steele, William Darko, Christopher D Miller
PURPOSE: To determine whether there is an association between higher vancomycin trough concentrations and attainment of a calculated area under the concentration-time curve (AUC)/minimum inhibitory concentration (MIC) ≥400. METHODS: A retrospective analysis was conducted among vancomycin-treated adult patients with a positive methicillin-resistant Staphylococcus aureus (MRSA) culture. Attainment of a calculated AUC/MIC ≥400 was compared between patients with troughs in the reference range of 15 to 20 mg/L and those with troughs in the following ranges: <10, 10 to 14...
April 12, 2016: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/27073695/achievement-of-vancomycin-therapeutic-goals-in-critically-ill-patients-early-individualization-may-be-beneficial
#16
Bita Shahrami, Farhad Najmeddin, Sarah Mousavi, Arezoo Ahmadi, Mohammad Reza Rouini, Kourosh Sadeghi, Mojtaba Mojtahedzadeh
Objective. The aim of our study was to assess and validate the effectiveness of early dose adjustment of vancomycin based on first dose monitoring in achieving target recommended goal in critically ill patients. Methods. Twenty critically ill patients with sepsis received loading dose of 25 mg/kg of vancomycin and then were randomly assigned to 2 groups. Group 1 received maximum empirical doses of vancomycin of 15 mg/kg every 8 hrs. In group 2, the doses were individualized based on serum concentrations of vancomycin...
2016: Critical Care Research and Practice
https://www.readbyqxmd.com/read/27029221/investigation-on-rifampicin-administration-from-the-standpoint-of-pharmacokinetics-pharmacodynamics-in-a-neutropenic-murine-thigh-infection-model
#17
Jun Hirai, Mao Hagihara, Hideo Kato, Daisuke Sakanashi, Naoya Nishiyama, Yusuke Koizumi, Yuka Yamagishi, Hiroyuki Suematsu, Hideaki Hanaki, Hiroshige Mikamo
BACKGROUND: The purpose of this study was to examine the pharmacokinetics/pharmacodynamics of rifampicin against methicillin-susceptible Staphylococcus aureus (MSSA), methicillin-resistant S. aureus (MRSA), and vancomycin-intermediate S. aureus (VISA) in a neutropenic murine thigh infection model. METHODS: Three S. aureus isolates (MSSA [ATCC 25923], MRSA and VISA [Mu50]) with rifampicin MIC 0.06 to >256 μg/mL were tested. The efficacy was calculated as the change in bacterial density...
June 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/26997930/vancomycin-dosing-and-pharmacokinetics-in-postoperative-pediatric-cardiothoracic-surgery-patients
#18
Emily C Benefield, Tracy M Hagemann, H Christine Allen, Kevin Farmer, Michael E Burton, Susana Chavez-Bueno, Peter N Johnson
OBJECTIVES: This study compared vancomycin trough concentrations and pharmacokinetic parameters in pediatric cardiothoracic surgery (CTS) patients versus those in controls receiving 20 mg/kg/dose, intravenously, every 8 hours. METHODS: A retrospective study was conducted in children <18 years of age, following CTS, versus an age-and sex-matched control group. The primary objective was to determine differences in trough concentrations between groups. Secondary objectives included comparisons of pharmacokinetics between groups and development of vancomycin-associated acute kidney injury (AKI), defined as a doubling in serum creatinine from baseline...
January 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/26982169/small-colony-variants-in-persistent-and-recurrent-staphylococcus-aureus-bacteremia
#19
Nak-Hyun Kim, Yu Min Kang, Woong Dae Han, Kyoung Un Park, Kay-Hyun Park, Jae Il Yoo, Dong-Gun Lee, Chulmin Park, Kyoung-Ho Song, Eu Suk Kim, Sang Won Park, Nam Joong Kim, Myoung-Don Oh, Hong Bin Kim
The small-colony variant (SCV) phenotype of Staphylococcus aureus is associated with intracellular persistence and reduced antimicrobial susceptibility, which can lead to therapeutic failure. Since SCVs grow slowly and have a confusing morphology, the identification of infections due to SCV is difficult. We have identified SCVs in two patients who presented with persistent methicillin-resistant Staphylococcus aureus (MRSA) bacteremia complicated by surgical site infections after cardiothoracic surgery. Nine blood isolates were collected from the two patients for species identification, antimicrobial susceptibility testing, and phenotypic and genotypic characterization...
October 2016: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
https://www.readbyqxmd.com/read/26926670/switching-from-intermittent-to-continuous-infusion-of-vancomycin-in-critically-ill-patients-toward-a-more-robust-exposure
#20
Erik M van Maarseveen, Suzan Gipmans, Erwin Vasbinder, Manfred Petjak, Arthur R H van Zanten
BACKGROUND: To increase target attainment rates, switching the mode of administration from intermittent (InI) to continuous infusion (CoI) has been proposed. In this study, target attainment rates and interpatient variation in exposure were compared between vancomycin InI- and CoI-treated critically ill patients. METHODS: An observational cohort study was conducted among critically ill patients admitted to a level-2 intensive care unit. Adult patients (18 years or older) treated with intravenous vancomycin for various indications, including sepsis, pneumonia, and endocarditis between 2007 and 2013 were eligible for inclusion...
June 2016: Therapeutic Drug Monitoring
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