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Vancomycin pharmacokinetics

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https://www.readbyqxmd.com/read/28416551/comparative-pharmacodynamics-of-telavancin-and-vancomycin-in-the-neutropenic-murine-thigh-and-lung-infection-models-against-staphylococcus-aureus
#1
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 S. aureus strains were included. The telavancin MIC ranged from 0.06 - 0.25 mg/L and vancomycin MIC from 1 - 4 mg/L. Plasma pharmacokinetics of escalating doses (1.25, 5, 20 and 80 mg/kg) of telavancin and vancomycin were linear over the dose range. Epithelial lining fluid (ELF) pharmacokinetics for each drug revealed penetration into the ELF mirrored the percent free fraction (not protein bound) in plasma for each drug...
April 17, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28406088/population-pharmacokinetics-of-vancomycin-in%C3%A2-chinese-infants%C3%A2
#2
Xiao-Yan Sheng, Chao-Yang Chen, Ling-Yue Ma, Ya-Ou Liu, Ying Zhou, Yi-Min Cui
OBJECTIVE: To determine the pharmacokinetics (PK) of vancomycin in Chinese infant patients using a population pharmacokinetic (PKK) approach in order to provide support for individualized vancomycin therapy. METHOD: The data included 72 sets of steady-state peak and trough serum concentrations from 61 infants (0 - 1 years). PPK analysis was performed using the nonlinear mixed-effects modeling software. Inter- and intraindividual variability was estimated for the clearance and distribution volume of vancomycin...
April 13, 2017: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28401341/vancomycin-prophylaxis-for-total-joint-arthroplasty-incorrectly-dosed-and-has-a-higher-rate-of-periprosthetic-infection-than-cefazolin
#3
Michael M Kheir, Timothy L Tan, Ibrahim Azboy, Dean D Tan, Javad Parvizi
BACKGROUND: In total joint arthroplasty (TJA), vancomycin is used as perioperative antibiotic prophylaxis in patients with penicillin allergy or in patients colonized with methicillin-resistant Staphylococcus aureus (MRSA). Although vancomycin dosing should be weight-based (15 mg/kg), not all surgeons are aware of this; a fixed 1-g dose is instead frequently administered. QUESTIONS/PURPOSES: (1) Is there a difference in the risk of periprosthetic joint infection (PJI) in patients receiving vancomycin or cefazolin prophylaxis after primary TJA? (2) What proportion of patients is adequately dosed with vancomycin? (3) Compared with actual fixed dosing, does weight-based dosing result in a greater proportion of patients staying above the recommended 15-mg/L level at the beginning and end of surgery? (4) Are patients overdosed with vancomycin at greater risk of developing nephrotoxicity and acute kidney injury? METHODS: A single-institution, retrospective study was performed on 1828 patients undergoing primary TJAs who received vancomycin prophylaxis between 2008 and 2014...
April 11, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28350900/gram-positive-bacterial-infections-research-priorities-accomplishments-and-future-directions-of-the-antibacterial-resistance-leadership-group
#4
Sarah B Doernberg, Thomas P Lodise, Joshua T Thaden, Jose M Munita, Sara E Cosgrove, Cesar A Arias, Helen W Boucher, G Ralph Corey, Franklin D Lowy, Barbara Murray, Loren G Miller, Thomas L Holland
Antimicrobial resistance in gram-positive bacteria remains a challenge in infectious diseases. The mission of the Gram-Positive Committee of the Antibacterial Resistance Leadership Group (ARLG) is to advance knowledge in the prevention, management, and treatment of these challenging infections to improve patient outcomes. Our committee has prioritized projects involving methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) due to the scope of the medical threat posed by these pathogens...
March 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28350363/determination-of-vancomycin-in-human-serum-by-cyclodextrin-micellar-electrokinetic-capillary-chromatography-cd-mekc-and-application-for-pdap-patients
#5
Jiajing Wang, Yuqing Cao, Shengyuan Wu, Shuowen Wang, Xin Zhao, Tingting Zhou, Yuefen Lou, Guorong Fan
A simple and sensitive cyclodextrin-micellar electrokinetic capillary chromatography (CD-MEKC) method with UV detection was developed and validated for the determination of vancomycin (VCM) in serum. The separation was achieved in 14 min at 25 °C with a fused-silica capillary column of 40.2 cm × 50 mm i.d. (effective length 30.2 cm) and a run buffer containing 25 mM borate buffer with 50 mM sodium dodecylsulfonate (SDS) (pH 9.5) and 2% sulfobutyl-β-cyclodextrin (sulfobutyl-β-CD). Under optimal conditions for biological samples, good separations with high efficiency and short analysis time were achieved...
March 28, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/28337080/vancomycin-auc-mic-and-corresponding-troughs-in-a-pediatric-population
#6
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/28297816/-population-pharmacokinetics-of-vancomycin-from-severe-in-patients-with-lower-respiratory-tract-infection
#7
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
#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-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
#9
REVIEW
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...
July 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28257285/population-pharmacokinetics-of-vancomycin-in-chinese-pediatric-patients%C3%A2
#10
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
#11
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
#12
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
#13
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
#14
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...
2017: Nephron
https://www.readbyqxmd.com/read/28129819/-evaluation-of-clinical-evidence-for-dalbavancin
#15
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
#16
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
#17
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
#18
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
#19
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/peak-measurement-for-vancomycin-auc-estimation-in-obese-adults-improves-precision-and-lowers-bias
#20
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
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