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Vancomycin pharmacokinetics

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https://www.readbyqxmd.com/read/28297816/-population-pharmacokinetics-of-vancomycin-from-severe-in-patients-with-lower-respiratory-tract-infection
#1
W Yang, B He, C H Deng
Objective: To develop a population pharmacokinetic (PPK) model of vancomycin in Chinese inpatients with severe lower respiratory tract infection. Methods: We gathered serum concentrations of vancomycin from inpatients who received vancomycin during Nov 2011 to Nov 2012.Vancomycin serum concentrations was measured by high performance liquid chromatography. Vancomycin PPK analysis was performed using nonlinear mixed effects model (NONMEM) program. Results: We gathered the data of 70 inpatients with lower respiratory tract infection at respiratory ward or respiratory intensive care unit(RICU) between Nov 2011 to Nov 2012 [58 males, 12 females; 78(23-91) years old; the mean of APACHⅡ score was 16...
March 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28289024/evaluation-of-a-bayesian-approach-to-estimate-vancomycin-exposure-in-obese-patients-with-limited-pharmacokinetic-sampling-a-pilot-study
#2
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-hour vancomycin area under the curve estimation (AUC) with limited PK sampling in adult obese patients receiving vancomycin for suspected or confirmed Gram-positive infections. This was an IRB-approved prospective evaluation of 12 patients. Patients had a median (95% CI) age of 61 years (39 - 71), creatinine clearance of 86 mL/min (75 - 120), and body mass index of 45 kg/m(2) (40 - 52). For each patient, five PK concentrations were measured and 4 different vancomycin population PK models were used as Bayesian priors to estimate the estimate vancomycin AUC (AUCFULL)...
March 13, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28264598/review-of-the-pharmacokinetics-of-dalbavancin-a-recently-approved-lipoglycopeptide-antibiotic
#3
Ranjeet Prasad Dash, R Jayachandra Babu, Nuggehally R Srinivas
Dalbavancin, a recently approved glycopeptide antibiotic, whose disposition is not affected by renal function as compared to vancomycin is used to treat serious infections caused by Staphylococci and Streptococci including multiple drug-resistant strains. Although reviews of the pharmacodynamic and clinical efficacy of dalbavancin have been published, a comprehensive overview of the pharmacokinetic properties including distribution and disposition in animals and humans has not been published. The aim of this review is to summarize the pharmacokinetics of dalbavancin, which justifies the intravenous dosing regimens and to provide considerations and perspectives with regard to dosing strategies...
March 6, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28257285/population-pharmacokinetics-of-vancomycin-in-chinese-pediatric-patients%C3%A2
#4
Taotao Liu, Chen Deng, Daohai Cheng, Tianyan Zhou, Hua Lu, Wenxing Wei, Wei Lu
OBJECTIVE: This study was conducted to develop a population pharmacokinetic (PopPK) model for vancomycin and to detect the significant covariates that influence the PopPKs to facilitate individualized therapy for Chinese pediatric patients. METHODS: Patients ≤ 10 years old who received vancomycin for ≥ 72 hours between 2007 and 2010 were analyzed using a nonlinear mixed-effects modeling approach (-NONMEM). A one-compartment model with first-order elimination was chosen to depict the data...
March 3, 2017: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28249208/diphenylurea-derivatives-for-combating-methicillin-and-vancomycin-resistant-staphylococcus-aureus
#5
Ibrahim H Eissa, Haroon Mohammad, Omar A Qassem, Waleed Younis, Tamer M Abdelghany, Ahmed Elshafeey, Mahmoud M Abd Rabo Moustafa, Mohamed N Seleem, Abdelrahman S Mayhoub
A new class of diphenylurea was identified as a novel antibacterial scaffold with an antibacterial spectrum that includes highly resistant staphylococcal isolates, namely methicillin- and vancomycin-resistant Staphylococcus aureus (MRSA & VRSA). Starting with a lead compound 3 that carries an aminoguanidine functionality from one side and a n-butyl moiety on the other ring, several analogues were prepared. Considering the pharmacokinetic parameters as a key factor in structural optimization, the structure-activity-relationships (SARs) at the lipophilic side chain were rigorously examined leading to the discovery of the cycloheptyloxyl analogue 21n as a potential drug-candidate...
April 21, 2017: European Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/28242672/towards-individualised-vancomycin-dosing-in-methicillin-resistant-staphylococcus-aureus-bacteraemia-establishment-of-an-auc0-24-threshold-for-nephrotoxicity
#6
R Chavada, N Ghosh, I Sandaradura, M Maley, S J Van Hal
Background: Unlike vancomycin trough concentrations, data on the utility of vancomycin pharmacokinetic (PK) parameters, namely the AUC0-24, in predicting acute kidney injury (AKI) are limited. Our aim was to investigate this relationship in patients receiving vancomycin therapy for methicillin resistant Staphylococcus aureus bacteraemia (MRSA-B).Methods: A single centre retrospective observational cohort study involving 127 consecutive MRSA-B patients was conducted to examine the incidence of AKI, (defined as serum creatinine ≥0...
February 27, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28224048/wound-penetration-of-cefazolin-ciprofloxacin-piperacillin-tazobactam-and-vancomycin-during-negative-pressure-wound-therapy
#7
Matthew P Rowan, Krista L Niece, Julie A Rizzo, Kevin S Akers
Objective: Negative pressure wound therapy (NPWT) uses subatmospheric pressure as a noninvasive adjunct to treat wounds and has demonstrated clinical efficacy by accelerating healing of a variety of acute and chronic wounds. NPWT may also play a role in preventing or treating wound infections, possibly by increasing wound penetration of antibiotics. However, clinical data in patients undergoing antibiotic and NPWT treatment are limited. Approach: To evaluate the wound penetration of antibiotics in NPWT patients, we conducted a prospective, observational study of burn and trauma patients treated with NPWT and systemic antibiotics...
February 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28152540/vancomycin-during-the-last-hour-of-the-hemodialysis-session-a-pharmacokinetic-analysis
#8
Lila Ghouti-Terki, Elodie Chasseuil, Nolwenn Rabot, Gilles Paintaud, Maud François, Béatrice Birmelé, François Darrouzain, Matthias Büchler, Jean-Michel Halimi, David Ternant
BACKGROUND: Vancomycin is usually administered after the dialysis sessions to patients undergoing hemodialysis. Administration of vancomycin during (as opposed to after) sessions would save time, and would be more acceptable to patients and staff, but may lead to vancomycin underexposure. The aim of this study was to propose a new dosing regimen of vancomycin taking into account the dialysis-related losses of vancomycin when administered during dialysis. METHODS: In this monocentric prospective study, vancomycin was infused to dialyzed patients during the last hour of the dialysis session at increased doses...
February 3, 2017: Nephron
https://www.readbyqxmd.com/read/28129819/-evaluation-of-clinical-evidence-for-dalbavancin
#9
Dolors Rodríguez-Pardo
Gram-positive infections are currently a therapeutic challenge because of the emergence of strains resistant to first-line antibiotics. Consequently, in the last few years, new antibiotics have been developed with activity against multiresistant Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus and strains with intermediate sensitivity to vancomycin. Among the new antibiotics approved for the treatment of these microorganisms, dalbavancin is a semisynthetic lipoglycopeptide derived from teicoplanin, but has a superior efficacy profile to the latter...
January 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/28129815/-dalbavancin-breakpoints-and-recommendations-for-in-vitro-study-of-its-activity
#10
Rafael Cantón, María Díez-Aguilar, María Isabel Morosini
Dalbavancin is a semisynthetic lipoglycopeptide approved for the treatment of acute skin and soft tissue infections due to Gram-positive microorganisms susceptible to this antimicrobial agent. The FDA (Food and Drug Administration) and the EUCAST (European Committee on Antimicrobial Susceptibility Testing) have established clinical breakpoints to interpret the results of the antibiogram (expressed as MIC [minimum inhibitory concentration]) with approved doses (1g intravenously [IV] followed by 0.5g IV at day 8 or 1...
January 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/28125179/an-approach-to-optimise-therapeutic-vancomycin-dosage-in-a-haemodialysis-population
#11
H Gunning, G Taylor, A Smyth, G Mellotte, J Fennell, P Murphy, P Lavin, C Wall
Haemodialysis patients are at risk of gram-positive bacteraemia and commonly require intravenous vancomycin. Intravenously administered vancomycin is primarily excreted by the kidney and exhibits complex pharmacokinetics in haemodialysis patients; achieving therapeutic levels can be challenging. An audit in our unit showed current practises of vancomycin administration resulted in a high proportion of sub-therapeutic levels. A new protocol was developed with fixed weight-based loading and subsequent dosing guided by pre-dialysis levels, target levels were 10-20mg/L...
October 12, 2016: Irish Medical Journal
https://www.readbyqxmd.com/read/28118218/obesity-and-skin-and-soft-tissue-infections-how-to-optimize-antimicrobial-usage-for-prevention-and-treatment
#12
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/28099635/currently-used-dosage-regimens-of-vancomycin-fail-to-achieve-therapeutic-levels-in-approximately-40-of-intensive-care-unit-patients
#13
Vitor Yuzo Obara, Carolina Petrus Zacas, Claudia Maria Dantas de Maio Carrilho, Vinicius Daher Alvares Delfino
Objective: This study aimed to assess whether currently used dosages of vancomycin for treatment of serious gram-positive bacterial infections in intensive care unit patients provided initial therapeutic vancomycin trough levels and to examine possible factors associated with the presence of adequate initial vancomycin trough levels in these patients. Methods: A prospective descriptive study with convenience sampling was performed. Nursing note and medical record data were collected from September 2013 to July 2014 for patients who met inclusion criteria...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28096158/vancomycin-area-under-the-curve-estimation-in-obese-adults-the-peak-improves-precision-and-lowers-bias
#14
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/28079262/pediatric-obesity-pharmacokinetic-alterations-and-effects-on-antimicrobial-dosing
#15
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/28039606/development-of-a-physiologically-based-pharmacokinetic-modelling-approach-to-predict-the-pharmacokinetics-of-vancomycin-in-critically-ill-septic-patients
#16
Christian Radke, Dagmar Horn, Christian Lanckohr, Björn Ellger, Michaela Meyer, Thomas Eissing, Georg Hempel
BACKGROUND AND OBJECTIVES: Sepsis is characterised by an excessive release of inflammatory mediators substantially affecting body composition and physiology, which can be further affected by intensive care management. Consequently, drug pharmacokinetics can be substantially altered. This study aimed to extend a whole-body physiologically based pharmacokinetic (PBPK) model for healthy adults based on disease-related physiological changes of critically ill septic patients and to evaluate the accuracy of this PBPK model using vancomycin as a clinically relevant drug...
December 31, 2016: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28017667/assessment-of-optimal-initial-dosing-regimen-with-vancomycin-pharmacokinetics-model-in-very-low-birth-weight-neonates
#17
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
#18
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
#19
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/27920562/the-pharmacokinetics-of-vancomycin-during-the-initial-loading-dose-in-patients-with-septic-shock
#20
Wasan Katip, Sutep Jaruratanasirikul, Sutthiporn Pattharachayakul, Wibul Wongpoowarak, Arnurai Jitsurong, Aroonrut Lucksiri
OBJECTIVE: To characterize the pharmacokinetics (PK) of vancomycin in patients in the initial phase of septic shock. METHODS: Twelve patients with septic shock received an intravenous infusion of vancomycin 30 mg/kg over 2 h. The vancomycin PK study was conducted during the first 12 h of the regimen. Serum vancomycin concentration-time data were analyzed using the standard model-independent analysis and the compartment model. RESULTS: For the noncompartment analysis the mean values ± standard deviation (SD) of the estimated clearance and volume of distribution of vancomycin at steady state were 6...
2016: Infection and Drug Resistance
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