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vancomycin trough

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https://www.readbyqxmd.com/read/29109576/baseline-competency-assessment-of-pharmacists-prescribing-and-managing-vancomycin-therapy-in-the-regina-qu-appelle-health-region
#1
Kirsten Tangedal, Jennifer Bolt, Suzanne Len, Ali Bell
Background: Pharmacists in the Regina Qu'Appelle Health Region (RQHR), Saskatchewan, independently dose, monitor, and adjust vancomycin therapy. No framework exists for ongoing competency assessment of pharmacists. Objectives: The primary objective was to determine pharmacists' overall level of competency for all components of the vancomycin prescribing procedure. The secondary objectives were to determine competency for individual prescribing phases, to stratify overall competency in relation to pharmacist and patient factors, and to identify the 3 most frequent errors...
September 2017: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/29097070/characterization-of-variables-for-potential-impact-on-vancomycin-pharmacokinetics-in-thermal-or-inhalation-injury
#2
Katie Elder, David M Hill, William L Hickerson
OBJECTIVE: To characterize the pharmacokinetics of vancomycin dosing in thermal or inhalation injury as they relate to percent total body surface area burn (TBSA) and days since injury (DSI). METHODS: This retrospective 3-year study included patients with thermal or inhalation injury receiving vancomycin. Patient demographics and course data were collected using the institution's electronic medical record. RESULTS: Six hundred and fifty-four patients were included in the study; 124 remained after exclusion...
October 30, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29095798/relationship-between-initial-vancomycin-trough-levels-and-early-onset-vancomycin-associated-nephrotoxicity-in-critically-ill-patients
#3
Masayuki Chuma, Makoto Makishima, Toru Imai, Naohiro Tochikura, Shinichiro Suzuki, Tsukasa Kuwana, Nami Sawada, Tomohide Komatsu, Takako Sakaue, Norikazu Kikuchi, Yoshikazu Yoshida, Kosaku Kinoshita
BACKGROUND: Appropriate initial dosing of vancomycin (VCM) is important in improving survival and in preventing nephrotoxicity in critically ill patients, but the potential relationship between initial VCM trough levels and early-onset nephrotoxicity remains unclear. We examined the relationship between initial VCM trough levels and early-onset VCM-associated nephrotoxicity. METHODS: We performed a retrospective study of patients who had therapeutic drug monitoring of VCM with initial trough levels within 4 days after the beginning of VCM administration...
October 31, 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/29084032/dosopt-a-tool-for-personalized-bayesian-dose-adjustment-of-vancomycin-in-neonates
#4
Tõnis Tasa, Tuuli Metsvaht, Riste Kalamees, Jaak Vilo, Irja Lutsar
BACKGROUND: Our main aim has been to design a framework to improve vancomycin dosing in neonates. This required the development and verification of a computerized dose adjustment application, DosOpt, to guide the selection. METHODS: Model fitting in DosOpt uses Bayesian methods for deriving individual pharmacokinetic (PK) estimates from population priors and patient therapeutic drug monitoring measurements. These are used to simulate concentration-time curves and target-constrained dose optimization...
December 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/29042837/vancomycin-dosing-in-pediatric-extracorporeal-membrane-oxygenation-potential-impacts-of-new-technologies
#5
Kevin P Lonabaugh, Kelly J Lunsford, Gary Y Fang, David A Kaufman, Samuel D Addison, Marcia L Buck
OBJECTIVES: The objective of the current study was to evaluate the doses of vancomycin used to obtain therapeutic drug concentrations in pediatric patients on extracorporeal membrane oxygenation (ECMO), using new ECMO technologies. METHODS: This was a single-center, retrospective study of patients treated with vancomycin while receiving ECMO using low-volume circuit technology. RESULTS: A total of 28 patients were included in the analysis of the primary endpoint...
September 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29038392/urine-vancomycin-level-as-a-method-for-drug-monitoring-in-patients-with-normal-and-decreased-kidney-function
#6
Shervin Shokouhi, Ilad Alavi Darazam, Ziba Ayoubian, Mohammad M Sajadi
INTRODUCTION: Therapeutic drug monitoring of vancomycin is an important issue in clinical decision-making and dosage modifying, particularly among patients in critical conditions and decreased kidney function. Urine is typically readily available in hospitalized patients and therapeutic drug monitoring in urine may be a reliable and noninvasive procedure compared to frequent blood sampling. We aimed to determine and validate the diagnostic yield of vancomycin trough level in urine. MATERIALS AND METHODS: In a prospective study, 95 patients who were treated with vancomycin for any clinical condition were enrolled in this study...
October 2017: Iranian Journal of Kidney Diseases
https://www.readbyqxmd.com/read/28992126/association-between-vancomycin-trough-concentrations-and-duration-of-methicillin-resistant-staphylococcus-aureus-bacteremia-in-children
#7
Alice J Hsu, Rana F Hamdy, Yanjie Huang, Jared A Olson, Shahira Ghobrial, Jeffrey S Gerber, Adam L Hersh, Pranita D Tamma
In a multicenter retrospective study, we sought to determine the optimal vancomycin trough concentration that would impact the duration of methicillin-resistant Staphylococcus aureus bacteremia in children. We found that a median vancomycin trough concentration of <10 µg/mL within the first 72 hours may be associated with a longer duration of bacteremia compared to a median trough concentration of ≥10 µg/mL.
September 14, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28983789/acute-kidney-injury-in-necrotizing-enterocolitis-predicts-mortality
#8
Cory N Criss, David T Selewski, Bipin Sunkara, Joshua S Gish, Lily Hsieh, Jennifer S Mcleod, Jason O Robertson, Niki Matusko, Samir K Gadepalli
BACKGROUND: Morbidity and mortality with necrotizing enterocolitis (NEC) remains a significant challenge. Acute kidney injury (AKI) has been shown to worsen survival in critically ill neonates. To our knowledge, this study is the first to evaluate the prevalence of AKI and its impact on outcomes in neonatal NEC. METHODS: We carried out a single-center retrospective chart review of all neonates treated for NEC between 2003 and 2015 (N = 181). AKI is defined as a rise in serum creatinine (SCr) from a previous trough according to neonatal modified KDIGO criteria (stage 1 = SCr rise 0...
October 5, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28983082/full-hydrodynamic-reversibility-of-the-weak-dimerization-of-vancomycin-and-elucidation-of-its-interaction-with-vans-monomers-at-clinical-concentration
#9
Mary K Phillips-Jones, Ryan Lithgo, Vlad Dinu, Richard B Gillis, John E Harding, Gary G Adams, Stephen E Harding
The reversibility and strength of the previously established dimerization of the important glycopeptide antibiotic vancomycin in four different aqueous solvents (including a medically-used formulation) have been studied using short-column sedimentation equilibrium in the analytical ultracentrifuge and model-independent SEDFIT-MSTAR analysis across a range of loading concentrations. The change in the weight average molar mass M w with loading concentration was consistent with a monomer-dimer equilibrium. Overlap of data sets of point weight average molar masses M w(r) versus local concentration c(r) for different loading concentrations demonstrated a completely reversible equilibrium process...
October 5, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28976419/predictive-performance-of-vancomycin-trough-concentrations-in-patients-with-diabetes-with-microalbuminuria
#10
Hiroshi Kimura, Marie Shigematsu, Akihiro Tanaka, Shinichi Watanabe, Shingo Takatori, Mamoru Tanaka, Takashi Mizuma, Hiroaki Araki
BACKGROUND: The performance of a population pharmacokinetic model in predicting trough concentrations after the initial vancomycin dose was evaluated in patients with albuminuria compared with patients who did not have albuminuria. METHODS: Data were collected from 52 patients infected with methicillin-resistant Staphylococcus aureus (excluding patients undergoing dialysis and acute kidney injury) and treated with vancomycin. The data included urinary albumin concentration...
December 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28970410/early-vancomycin-concentrations-and-the-applications-of-a-pharmacokinetic-extrapolation-method-to-recognize-sub-therapeutic-outcomes
#11
Oscar Santalo, Umima Baig, Mara Poulakos, Daniel Brown
Vancomycin trough concentrations should be measured within 30 min of the next dose, but studies have shown that troughs are often measured too early, producing erroneous results that could lead to dosing errors. The purpose of this study was to identify the frequency of early trough measurements and to evaluate whether pharmacokinetically extrapolating mistimed concentrations may locate sub-therapeutic concentrations. Vancomycin troughs were retrospectively reviewed. For troughs ≥10 mg/L and measured >0...
November 10, 2016: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/28948652/pharmacokinetic-changes-of-antibiotic-antiviral-antituberculosis-and-antifungal-agents-during-extracorporeal-membrane-oxygenation-in-critically-ill-adult-patients
#12
REVIEW
J Hahn, J H Choi, M J Chang
WHAT IS KNOWN AND OBJECTIVE: Extracorporeal membrane oxygenation (ECMO) is a life-saving system used for critically ill patients with cardiac and/or respiratory failure. The pharmacokinetics (PK) of drugs can change in patients undergoing ECMO, which can result in therapeutic failure or drug toxicity requiring further management of drug complications. In this review, we discussed changes in the PK of antibiotic, antiviral, antituberculosis and antifungal agents administered to adult patients on ECMO...
September 25, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28936957/-pk-pd-of-vancomycin-in-patients-with-severe-acute-pancreatitis-combined-with-augmented-renal-clearance
#13
Juan He, Enqiang Mao, Feng Jing, Huiting Jiang, Wenyun Xu, Wanhua Yang, Erzhen Chen
OBJECTIVE: To evaluate the serum trough concentration and the pharmacokinetics/pharmacodynamics (PK/PD) of vancomycin in patients with severe acute pancreatitis (SAP), and analyze the effect of vancomycin continuous infusion for optimizing the characteristics of its PK/PD. METHODS: The inhospital patients with SAP received vancomycin treatment and admitted to emergency intensive care unit (EICU) of Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2011 to December 2016 were enrolled...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28923869/the-impact-of-vancomycin-area-under-the-concentration-time-curve-guided-dosing-on-vancomycin-associated-nephrotoxicity-a-quasi-experiment
#14
Natalie A Finch, Evan J Zasowski, Kyle P Murray, Ryan P Mynatt, Jing J Zhao, Raymond Yost, Jason M Pogue, Michael J Rybak
Background: Evidence suggests maintaining vancomycin trough concentrations between 15 and 20 mg/L, as currently recommended, is frequently unnecessary to achieve the daily area under the concentration-time curve (AUC24h) target of ≥ 400 mg*h/L. Many patients with trough concentrations in this range have AUC24h in excess of the therapeutic threshold and within the exposure range associated with nephrotoxicity. Based on this, the Detroit Medical Center switched from trough concentration to AUC-guided dosing to minimize potentially unnecessary vancomycin exposure...
September 18, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28906422/increased-risk-of-acute-kidney-injury-in-critically-ill-children-treated-with-vancomycin-and-piperacillin-tazobactam
#15
Maya R Holsen, Calvin J Meaney, Amanda B Hassinger, Nicholas M Fusco
OBJECTIVES: Compare the rates of acute kidney injury in critically ill children treated with vancomycin and piperacillin-tazobactam versus vancomycin and ceftriaxone. DESIGN: Retrospective cohort study. SETTING: A large tertiary care children's hospital in an urban setting. PATIENTS: Children greater than or equal to 2 months old admitted to the PICU who received greater than or equal to 48 consecutive hours of vancomycin and piperacillin-tazobactam or vancomycin and ceftriaxone...
September 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28903517/association-of-vancomycin-trough-concentration-with-response-to-treatment-for-acute-pulmonary-exacerbation-of-cystic-fibrosis
#16
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/28885936/vancomycin-vs-vancomycin-piperacillin-tazobactam-associated-acute-kidney-injury-in-noncritically-ill-patients-at-a-tertiary-care-military-treatment-facility
#17
Caleb W Anderson, Kathy S Cazares, Michael B Lustik, Shivam M Patel, Troy M Denunzio
BACKGROUND: Broad-spectrum antibiotics are often used as initial empiric therapy in patients at risk for infections by multidrug-resistant organisms. Emerging literature and anecdotal reports within Tripler Army Medical Center indicate an increased incidence of vancomycin-associated acute kidney injury when used in combination with piperacillin-tazobactam. This is a retrospective, single-center study comparing the incidence of acute kidney injury in noncritically ill patients receiving either vancomycin or vancomycin in combination with piperacillin-tazobactam in a 206-bed tertiary care military training facility...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28867705/validating-the-effectiveness-of-switching-the-vancomycin-tdm-analysis-software-based-on-the-predictive-accuracy
#18
Shungo Imai, Takehiro Yamada, Nobuhisa Ishiguro, Takenori Miyamoto, Keisuke Kagami, Naoki Tomiyama, Yusuke Niinuma, Daisuke Nagasaki, Koji Suzuki, Akira Yamagami, Kumiko Kasashi, Masaki Kobayashi, Ken Iseki
Based on the predictive performance in our previous study, we switched the therapeutic drug monitoring (TDM) analysis software for dose setting of vancomycin (VCM) from "Vancomycin MEEK TDM analysis software Ver2.0" (MEEK) to "SHIONOGI-VCM-TDM ver.2009" (VCM-TDM) in January 2015. In the present study, our aim was to validate the effectiveness of the changing VCM TDM analysis software in initial dose setting of VCM. The enrolled patients were divided into two groups, each having 162 patients in total, who received VCM with the initial dose set using MEEK (MEEK group) or VCM-TDM (VCM-TDM group)...
2017: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/28846665/assessment-of-initial-vancomycin-dosing-in-pediatric-oncology-patients
#19
Hillary Orr, Deni Trone, Joshua Elder, Ashok Raj
This was a retrospective audit assessing vancomycin dosing of 60 mg/kg/day in the attainment of therapeutic concentrations between 10-20 mcg/mL among 56 pediatric oncology patients. Twelve patients (21%) achieved therapeutic concentrations of 10-20 mcg/mL, while 44 patients (79%) obtained trough levels below 10 mcg/mL despite the addition of nephrotoxic agents.
August 28, 2017: Children
https://www.readbyqxmd.com/read/28836582/influences-of-renal-function-descriptors-on-population-pharmacokinetic-modeling-of-vancomycin-in-chinese-adult-patients
#20
Xi-Wei Ji, Shuang-Min Ji, Xiao-Rong He, Xiao Zhu, Rong Chen, Wei Lu
Vancomycin, a glycopeptide antibiotic for the treatment of grampositive infections, is mainly eliminated via glomerular filtration. Thus, its therapeutic effects are affected predominantly by renal function. The aim of this study was to develop a population pharmacokinetic model of vancomycin for Chinese adult patients and to investigate the influence of different renal function descriptors on the predictability of the model. A retrospective analysis was performed based on the blood concentrations of vancomycin in 218 Chinese adult patients...
August 24, 2017: Acta Pharmacologica Sinica
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