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https://www.readbyqxmd.com/read/28544476/usefulness-of-a-decision-tree-model-for-the-analysis-of-adverse-drug-reactions-evaluation-of-a-risk-prediction-model-of-vancomycin-associated-nephrotoxicity-constructed-using-a-data-mining-procedure
#1
Shungo Imai, Takehiro Yamada, Kumiko Kasashi, Masaki Kobayashi, Ken Iseki
OBJECTIVES: Several publications concerning decision tree (DT) analysis in medical fields have recently demonstrated its usefulness for defining prognostic factors in various diseases. However, there are minimal reports on the predictors of adverse drug reactions. We attempted to use DT analysis to discover combinations of multiple risk factors that would increase the risk of nephrotoxicity associated with vancomycin (VCM). To demonstrate the usefulness of DT analysis, we compared its predictive performance with that of multiple logistic regression analysis...
May 23, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28532398/clinical-outcomes-of-linezolid-and-vancomycin-in-patients-with-nosocomial-pneumonia-caused-by-methicillin-resistant-staphylococcus-aureus-stratified-by-baseline-renal-function-a-retrospective-cohort-analysis
#2
Ping Liu, Blair Capitano, Amy Stein, Ali A El-Solh
BACKGROUND: The primary objective of this study is to assess whether baseline renal function impacts treatment outcomes of linezolid and vancomycin (with a dose-optimized regimen) for methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. METHODS: We conducted a retrospective cohort analysis of data generated from a prospective, randomized, controlled clinical trial (NCT 00084266). The analysis included 405 patients with culture-proven MRSA pneumonia. Baseline renal function was stratified based on creatinine clearance...
May 22, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28530212/-measurements-of-vancomycin-concentrations-in-the-blood-a-method-of-personalization-the-antibiotic-therapy-in-patients-with-chronic-kidney-disease
#3
Joanna Pondel, Piotr Krajewski, Natalia Królikowska, Aleksandra Tobiasz, Hanna Augustyniak-Bartosik, Magdalena Hurkacz
Therapeutic Drug Monitoring is a recognized method of personalizing treatment, having particular application in patients with chronic kidney disease who have frequent infections, requiring administration of vancomycin. International guidelines indicate the need to adjust the dose of the drug to the state of renal function. The recommended therapeutic ranges of minimum and maximum levels should be achieved in order to increase the effectiveness and safety of treatment. AIM: The aim of this study was to evaluate the usefulness of measuring the concentration of vancomycin in patients with chronic kidney disease due to bacterial infection...
April 21, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28522643/allometric-versus-consensus-guideline-dosing-in-achieving-target-vancomycin-trough-concentrations
#4
Matthew L Brown, Amber M Hutchison, Aaron M McAtee, Philippe R Gaillard, Darrell T Childress
PURPOSE: Results of a study comparing the performance of allometric versus consensus guideline-recommended vancomycin dosing in achieving initial trough concentrations within the desired range are reported. METHODS: A retrospective study was conducted to compare selected outcomes with 2 vancomycin dosing methods: (1) dosing by total body weight, as recommended in current consensus guidelines, and (2) a new empirical vancomycin dosing strategy grounded in allometry (the study of the relationship between body size and physiology)...
May 18, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28515506/impact-of-pharmacy-practice-model-expansion-on-pharmacokinetic-services-optimization-of-vancomycin-dosing-and-improved-patient-safety
#5
Zhe Han, Natasha N Pettit, Emily M Landon, Benjamin D Brielmaier
Background: The impact of pharmacy interventions on optimizing vancomycin therapy has been described, however interventions vary among studies and the most optimal pharmacy practice model (PPM) for pharmacokinetic (PK) services has not been established. Objective: The purpose of this study is to demonstrate the value of 24 hours a day, 7 days a week (24/7) PK services. Methods: New PK services were implemented in 2 phases with institutional PPM expansion. Phase 1 included universal monitoring by pharmacists with recommendations made to prescribers during business hours...
April 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28490050/is-trough-concentration-of-vancomycin-predictive-of-the-area-under-the-curve-a-commentary
#6
Anna-Karin Hamberg, Ron Keizer
No abstract text is available yet for this article.
June 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28457752/evaluation-of-the-variability-and-safety-of-serum-trough-concentrations-of-vancomycin-in-patients-admitted-to-the-intensive-care-unit
#7
Xiaodan Qian, Guantao Du, Chunmei Weng, Haijun Zhou, Xianju Zhou
OBJECTIVE: To examine the variability and safety of serum trough concentrations of vancomycin in patients admitted to the intensive care unit (ICU) and to analyze the factors influencing the trough concentration. METHODS: Data were collected retrospectively from ICU patients receiving vancomycin treatment at a fixed dose of 2g/day due to unobtainable weight data, at Changzhou No. 2 People's Hospital, between 2012 and 2015. Vancomycin trough concentrations were compared between groups stratified by sex, age, and estimated glomerular filtration rate (eGFR)...
April 27, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28444760/vancomycin-levels-are-frequently-subtherapeutic-in-critically-ill-patients-a-prospective-observational-study
#8
V Bakke, H Sporsem, E Von der Lippe, I Nordøy, Y Lao, H C Nyrerød, L Sandvik, K R Hårvig, J F Bugge, E Helset
BACKGROUND: Appropriate utilization of vancomycin is important to attain therapeutic targets while avoiding clinical failure and the development of antimicrobial resistance. Our aim was to observe the use of vancomycin in an intensive care population, with the main focus on achievement of therapeutic serum concentrations (15-20 mg/l) and to evaluate how this was influenced by dose regimens, use of guidelines and therapeutic drug monitoring. METHODS: A prospective observational study was carried out in the intensive care units at two tertiary hospitals in Norway...
April 25, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28406088/population-pharmacokinetics-of-vancomycin-in%C3%A2-chinese-infants%C3%A2
#9
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/28399057/staphylococcus-aureus-central-nervous-system-infections-in-children
#10
Jesus G Vallejo, Alexandra N Cain, Edward O Mason, Sheldon L Kaplan, Kristina G Hultén
BACKGROUND: Central nervous system (CNS) infections due to Staphylococcus aureus are uncommon in pediatric patients. We review the epidemiology, clinical features, and treatment in 68 patients with a S. aureus CNS infection evaluated at Texas Children's Hospital (TCH). METHODS: Cases of CNS infection in children with positive cerebrospinal fluid cultures or spinal epidural abscess for S. aureus at TCH from 2001-2013 were reviewed. RESULTS: 70 cases of S...
April 10, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28388921/establishment-of-a-new-initial-dose-plan-for-vancomycin-using-the-generalized-linear-mixed-model
#11
Yasuyuki Kourogi, Kenji Ogata, Norito Takamura, Jin Tokunaga, Nao Setoguchi, Mitsuhiro Kai, Emi Tanaka, Susumu Chiyotanda
BACKGROUND: When administering vancomycin hydrochloride (VCM), the initial dose is adjusted to ensure that the steady-state trough value (Css-trough) remains within the effective concentration range. However, the Css-trough (population mean method predicted value [PMMPV]) calculated using the population mean method (PMM) often deviate from the effective concentration range. In this study, we used the generalized linear mixed model (GLMM) for initial dose planning to create a model that accurately predicts Css-trough, and subsequently assessed its prediction accuracy...
April 8, 2017: Theoretical Biology & Medical Modelling
https://www.readbyqxmd.com/read/28360025/design-and-implementation-of-a-novel-web-based-e-learning-tool-for-education-of-health-professionals-on-the-antibiotic-vancomycin
#12
Stuart Evan Bond, Shelley P Crowther, Suman Adhikari, Adriana J Chubaty, Ping Yu, Jay P Borchard, Craig Steven Boutlis, Wilfred Winston Yeo, Spiros Miyakis
BACKGROUND: Traditional approaches to health professional education are being challenged by increased clinical demands and decreased available time. Web-based e-learning tools offer a convenient and effective method of delivering education, particularly across multiple health care facilities. The effectiveness of this model for health professional education needs to be explored in context. OBJECTIVES: The study aimed to (1) determine health professionals' experience and knowledge of clinical use of vancomycin, an antibiotic used for treatment of serious infections caused by methicillin-resistant Staphylococcus aureus (MRSA) and (2) describe the design and implementation of a Web-based e-learning tool created to improve knowledge in this area...
March 30, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28337080/vancomycin-auc-mic-and-corresponding-troughs-in-a-pediatric-population
#13
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/28289024/pilot-study-of-a-bayesian-approach-to-estimate-vancomycin-exposure-in-obese-patients-with-limited-pharmacokinetic-sampling
#14
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-h vancomycin area under the curve (AUC) with limited pharmacokinetic (PK) sampling in adult obese patients receiving vancomycin for suspected or confirmed Gram-positive infections. This was an Albany Medical Center Institutional Review Board-approved prospective evaluation of 12 patients. Patients had a median (95% confidence interval) age of 61 years (39 to 71 years), a median creatinine clearance of 86 ml/min (75 to 120 ml/min), and a median body mass index of 45 kg/m(2) (40 to 52 kg/m(2))...
May 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28245728/risk-factors-for-acute-kidney-injury-associated-with-the-treatment-of-bacterial-endocarditis-at-a-tertiary-academic-medical-center
#15
Brianne M Ritchie, Beth A Hirning, Craig A Stevens, Steven A Cohen, Jeremy R DeGrado
BACKGROUND: Acute kidney injury (AKI) is a common complication of endocarditis. OBJECTIVE: To determine risk factors for the development of AKI in patients treated for endocarditis. METHODS: This single centre, retrospective univariate and multivariate analysis to determine risk factors for the development of AKI included patients diagnosed with endocarditis between January 2009 and October 2013. RESULTS: Of 211 included patients, a total of 84 (39...
March 1, 2017: Journal of Chemotherapy
https://www.readbyqxmd.com/read/28242672/establishment-of-an-auc0-24-threshold-for-nephrotoxicity-is-a-step-towards-individualized-vancomycin-dosing-for-methicillin-resistant-staphylococcus-aureus-bacteremia
#16
R Chavada, N Ghosh, I Sandaradura, M Maley, S J Van Hal
Unlike vancomycin trough concentrations, data on the utility of vancomycin pharmacokinetic (PK) parameters, namely, the area under the concentration-time curve from 0 to 24 h (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 bacteremia (MRSA-B). A single-center retrospective observational cohort study involving 127 consecutive MRSA-B patients was conducted to examine the incidence of AKI (defined as serum creatinine of ≥0...
May 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28207512/incidence-and-risk-factors-of-acute-kidney-injury-associated-with-continuous-intravenous-high-dose-vancomycin-in-critically-ill-patients-a-retrospective-cohort-study
#17
Guillaume Lacave, Vincent Caille, Fabrice Bruneel, Catherine Palette, Stéphane Legriel, David Grimaldi, Mathilde Eurin, Jean-Pierre Bedos
For vancomycin therapy of severe infections, the Infectious Diseases Society of America recommends high vancomycin trough levels, whose potential for inducing nephrotoxicity is controversial. We evaluated the incidence and risk factors of acute kidney injury (AKI) in critically ill patients given continuous intravenous vancomycin with target serum vancomycin levels of 20 to 30 mg/L.We retrospectively studied 107 continuous intravenous vancomycin treatments of ≥48 hours' duration with at least 2 serum vancomycin levels ≥20 mg/L in critically ill patients...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28187757/the-association-between-vancomycin-trough-concentrations-and-acute-kidney-injury-in-the-neonatal-intensive-care-unit
#18
Vidit Bhargava, Michael Malloy, Rafael Fonseca
BACKGROUND: Vancomycin has recently gained popularity as an empiric therapy for late onset sepsis in the NICU. Changes in resistance patterns in common organisms has resulted in targeting higher trough concentrations of vancomycin. Consequently, an increase in vancomycin associated nephrotoxicity has been speculated. The objective of this study is to compare the incidence of acute kidney injury (AKI) in neonates with serum vancomycin trough concentrations less than 10 mg/L, 10-15 mg/L, or greater than 15 mg/L...
February 11, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28131530/cystatin-c-guided-vancomycin-dosing-in-critically-ill-patients-a%C3%A2-quality-improvement-project
#19
Erin Frazee, Andrew D Rule, John C Lieske, Kianoush B Kashani, Jason N Barreto, Abinash Virk, Philip J Kuper, Ross A Dierkhising, Nelson Leung
BACKGROUND: The aim of the study was to determine whether a vancomycin dosing algorithm based on estimated glomerular filtration rate from creatinine and cystatin C levels (eGFRcr-cys) improves target trough concentration achievement compared to an algorithm based on estimated creatinine clearance (eCLcr) in critically ill patients. STUDY DESIGN: This prospective quality improvement project evaluated intensive care unit (ICU) patients started on intravenous vancomycin using one of 2 different strategies...
May 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28109741/eight-unexpected-cases-of-vancomycin-associated-acute-kidney-injury-with-contemporary-dosing
#20
J Nicholas O'Donnell, Cybele Ghossein, Nathaniel J Rhodes, Jessica Peng, Tina Lertharakul, C Kim Pham, Marc H Scheetz
Vancomycin is one of the most commonly utilized antibiotics in US hospitals. It remains the drug of choice for the treatment of serious infections caused by methicillin-resistant Staphylococcus aureus. For many of these deep-seated infections, guidelines recommend achieving troughs of 15-20 mg/L for treatment efficacy. At our institution we observed a number of cases of presumed vancomycin-induced acute tubular necrosis clinically diagnosed by the nephrology service. We report eight cases of presumed vancomycin-induced acute tubular necrosis, three of which required hemodialysis before resolution of nephrotoxicity...
May 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
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