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Vancomycin continuous infusion

Jeffrey J Cies, Wayne S Moore, Kristen Nichols, Chad A Knoderer, Dominick M Carella, Arun Chopra
OBJECTIVES: To evaluate the population pharmacokinetics and pharmacodynamic target attainment of vancomycin in neonates with a contemporary ¼-inch extracorporeal life support circuit with a Quadrox-iD Pediatric oxygenator (Maquet Cardiovascular, LLC, Wayne, NJ). DESIGN: Retrospective medical record review. SETTING: Two free-standing tertiary/quaternary pediatric children's hospitals. PATIENTS: Neonates receiving either veno-arterial or veno-venous extracorporeal life support and vancomycin for empiric or definitive therapy with resulting serum concentrations...
June 22, 2017: Pediatric Critical Care Medicine
Martin Šíma, Karolína Hronová, Jan Hartinger, Ondřej Slanař
BACKGROUND: Delayed achievement of target vancomycin serum concentrations may adversely affect clinical outcomes. The objective of this retrospective study was to compare the prediction accuracy of different body weight descriptors for volume of distribution and to propose an optimal loading dose (LD) for continuous infusion regimens in adults. METHODS: Pharmacokinetic variables were computed using one-compartmental analysis. Simulated LDs of vancomycin were evaluated for each patient...
September 2017: Infectious Diseases
Gõkhan Metan, Leylagül Kaynar, Nuran Yozgat, Ferhan Elmali, Cemile Altay Kürkçüoglu, Emine Alp, Mustafa Çetin
After experiencing a high rate of carbapenem-resistant Gram-negative bacilli infections in febrile neutropenic patients, a two-stage intervention was introduced in the haematopoietic stem cell transplantation (HSCT) centre. During the first eight months of 2014, carbapenems remained the first choice for the empirical treatment of febrile neutropenia while the use of piperacillin/tazobactam (TZP) was encouraged in patients with stable clinical condition. When blood cultures were reported as negative and the patient was clinically stable the carbapenem/TZP treatment was stopped regardless of continuous fever and neutrophil count...
March 1, 2017: Le Infezioni in Medicina
Nuria Carballo, Marta De Antonio-Cuscó, Daniel Echeverría-Esnal, Sonia Luque, Esther Salas, Santiago Grau
INTRODUCTION: Community-acquired pneumonia (CAP) is associated with high morbidity and mortality rates. Despite methicillin-resistant Staphylococcus aureus (MRSA) having often been associated with nosocomial pneumonia, the condition of some MRSA CAP patients is severe enough to warrant their being admitted to ICU. OBJECTIVE: The purpose of this study is to conduct a systematic review of the literature on antibiotic treatment of MRSA CAP in critically-ill patients...
March 1, 2017: Farmacia Hospitalaria
Jonathan Sin, Kelly Newman, Hsin Lin
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
Romain Guilhaumou, Amélie Marsot, Julien Dupouey, Claire Galambrun, Audrey Boulamery, Carole Coze, Nicolas Simon, Nicolas André
BACKGROUND: In pediatric cancer patients, determination of optimal vancomycin dosage is essential because of high risk of inadequate concentrations and bacterial resistance. The aim of this study was to determine vancomycin pharmacokinetic parameters in this population and propose dosage optimization to achieve optimal concentration. METHODS: We retrospectively reviewed the use of vancomycin in pediatric cancer patients with febrile neutropenia (hematological or solid tumor disease)...
October 2016: Therapeutic Drug Monitoring
Louise Whitticase, Gemma Holder, Matt Cawsey, Alison Bedford-Russell
AIM: To compare continuous intravenous infusions of vancomycin in achieving desired therapeutic plasma concentrations against an intermittent bolus regimen. METHOD: Data were collected for all babies who received a continuous infusion of vancomycin on our Neonatal Intensive Care Unit (NICU) between October 2014 and March 2015. The regimen is based on that of another hospital (Hospital A) and comprised of a loading dose of 15 mg/kg over 1 hour followed by a continuous infusion of 20-50 mg/kg/day according to creatinine and corrected gestational age (CGA)...
September 2016: Archives of Disease in Childhood
Soomal Mohsin-Shaikh, Poonam Lumb
AIM: To audit whether a new paediatric vancomycin guideline is being adhered to and if therapeutic levels are being achieved. METHOD: Data on doses, age, weight, vancomycin levels, time taken and renal function were collected prospectively by reviewing drug charts of paediatric patients on vancomycin. The patients were followed for their whole vancomycin journey in order to observe if the guidelines were followed throughout. Data were collected between 7th and 30th January 2015...
September 2016: Archives of Disease in Childhood
Juwon Yim, Jordan R Smith, Katie E Barber, Jessica A Hallesy, Michael J Rybak
INTRODUCTION: In clinical trials comparing telavancin (TLV) with vancomycin for treatment of hospital-acquired pneumonia, TLV demonstrated lower clinical cure rates than vancomycin in patients who had mixed gram-positive and -negative infections and were concomitantly treated with either aztreonam (ATM) or piperacillin/tazobactam (PTZ). Here, we investigated therapeutic interactions between TLV and ATM or PTZ in an in vitro pharmacokinetic/pharmacodynamic (PK/PD) model under simulated reduced renal function conditions...
September 2016: Infectious Diseases and Therapy
Naiane Roveda Marsilio, Daiandy da Silva, Denise Bueno
OBJECTIVES: This study sought to identify the physical and chemical incompatibilities among the drugs administered intravenously to patients admitted to an adult intensive care unit. We also aimed to establish pharmaceutical guidelines for administering incompatible drugs. METHODS: This cross-sectional, prospective, and quantitative study was conducted from July to September 2015. Drug incompatibilities were identified based on an analysis of the patient prescriptions available in the hospital online management system...
June 2016: Revista Brasileira de Terapia Intensiva
Hsin Lin, Daniel Dante Yeh, Alexander R Levine
BACKGROUND: Limited data are available assessing vancomycin concentrations in obese critically ill patients. Currently, there are no studies evaluating dosing requirements in this population who receive vancomycin administered as a continuous infusion (CI). The aim of this study was to assess whether there was a difference in the weight-based maintenance dose required to reach a therapeutic vancomycin concentration at 24 hours when given as a CI in obese versus non-obese critically ill patients...
July 1, 2016: Critical Care: the Official Journal of the Critical Care Forum
R Chackupurakal, J Reessing, F Wappler, S G Sakka
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
Stefano Cristallini, Maya Hites, Hakim Kabtouri, Jason A Roberts, Marjorie Beumier, Frederic Cotton, Jeffrey Lipman, Frédérique Jacobs, Jean-Louis Vincent, Jacques Creteur, Fabio Silvio Taccone
Despite the development of new agents with activity against Gram-positive bacteria, vancomycin remains one of the primary antibiotics for critically ill septic patients. Because sepsis can alter antimicrobial pharmacokinetics, the development of an appropriate dosing strategy to provide adequate concentrations is crucial. The aim of this study was to prospectively validate a new dosing regimen of vancomycin given by continuous infusion (CI) to septic patients. We included all adult septic patients admitted to a mixed intensive care unit (ICU) between January 2012 and May 2013, who were treated with a new vancomycin CI regimen consisting of a loading dose of 35 mg/kg of body weight given as a 4-h infusion, followed by a daily CI dose adapted to creatinine clearance (CrCL), as estimated by the Cockcroft-Gault formula (median dose, 2,112 [1,500 to 2,838] mg)...
August 2016: Antimicrobial Agents and Chemotherapy
A Charmillon, E Novy, N Agrinier, M Leone, A Kimmoun, B Levy, B Demoré, J Dellamonica, C Pulcini
Our objective was to assess current practices about the administration (intermittent, extended, or continuous infusions) and therapeutic drug monitoring (TDM) of β-lactam antibiotics and vancomycin in France. We conducted a nationwide cross-sectional survey in May-August 2015, using an online questionnaire, sent as an e-mail link to infectious disease specialists and intensive care specialists through national mailing lists. We used clinical vignettes of critically ill patients to assess physicians' practices about administration and TDM practices for amoxicillin, cloxacillin, piperacillin/tazobactam, cefotaxime, ceftazidime, cefepime, meropenem and vancomycin...
July 2016: Clinical Microbiology and Infection
Cameron J Phillips, Alice J Wisdom, Vaughn S Eaton, Richard J Woodman, Ross A McKinnon
BACKGROUND: Revised international clinical guidelines for the antibiotic vancomycin have changed the advice pharmacists need to provide to medical and nursing colleagues. OBJECTIVES: (1) To determine the self-reported confidence of hospital pharmacists to provide contemporary advice on vancomycin and (2) to evaluate hospital pharmacists' knowledge to provide contemporary advice on vancomycin following a pilot continuing professional development (CPD) module. METHODS: The study was a prospective two-phase design in an Australian teaching hospital...
2016: SpringerPlus
Molly E Droege, Suzanne L Van Fleet, Eric W Mueller
Sepsis is associated with marked mortality, which may be reduced by prompt initiation of adequate, appropriate doses of antibiotic. Critically ill patients often have physiological changes that reduce blood and tissue concentrations of antibiotic and high rates of multidrug-resistant pathogens, which may affect patients' outcomes. All critical care professionals, including critical care nurses, should understand antibiotic pharmacokinetics and pharmacodynamics to ensure sound antibiotic dosing and administration strategies for optimal microbial killing and patients' outcomes...
April 2016: Critical Care Nurse
Jeffrey J Cies, Wayne S Moore, Susan B Conley, Mindy J Dickerman, Christine Small, Dominick Carella, Paul Shea, Jason Parker, Arun Chopra
Pharmacokinetic parameters can be significantly altered for both extracorporeal life support (ECLS) and continuous renal replacement therapy (CRRT). This case report describes the pharmacokinetics of continuous-infusion meropenem in a patient on ECLS with concurrent CRRT. A 2.8-kg, 10-day-old, full-term neonate born via spontaneous vaginal delivery presented with hypothermia, lethargy, and a ~500-g weight loss from birth. She progressed to respiratory failure on hospital day 2 (HD 2) and developed sepsis, disseminated intravascular coagulation, and liver failure as a result of disseminated adenoviral infection...
January 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
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
Jeffrey J Cies, Wayne S Moore, Susan B Conley, Samina Muneeruddin, Jason Parker, Paul Shea, Arun Chopra
OBJECTIVES: To describe our experience with achieving therapeutic serum vancomycin concentrations in pediatric continuous renal replacement therapy by using continuous infusion vancomycin by mixing vancomycin into the continuous renal replacement therapy solution. DESIGN: Retrospective chart review. SETTING: A 189-bed, freestanding children's tertiary care teaching hospital in Philadelphia, PA. PATIENTS: Pediatric patients receiving continuous renal replacement therapy from April 1, 2009, through December 31, 2014...
April 2016: Pediatric Critical Care Medicine
Rocío Álvarez, Luis E López Cortés, José Molina, José M Cisneros, Jerónimo Pachón
The increasing number of infections produced by beta-lactam-resistant Gram-positive bacteria and the morbidity secondary to these infections make it necessary to optimize the use of vancomycin. In 2009, the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Disease Pharmacists published specific guidelines about vancomycin dosage and monitoring. However, these guidelines have not been updated in the past 6 years. This review analyzes the new available information about vancomycin published in recent years regarding pharmacokinetics and pharmacodynamics, serum concentration monitoring, and optimal vancomycin dosing in special situations (obese people, burn patients, renal replacement therapy, among others)...
May 2016: Antimicrobial Agents and Chemotherapy
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