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https://www.readbyqxmd.com/read/29344778/the-relationship-between-vancomycin-trough-concentrations-and-auc-mic-ratios-in-pediatric-patients-a-qualitative-systematic-review
#1
REVIEW
Stacey Tkachuk, Kyle Collins, Mary H H Ensom
BACKGROUND: In adults, the area under the concentration-time curve (AUC) divided by the minimum inhibitory concentration (MIC) is associated with better clinical and bacteriological response to vancomycin in patients with methicillin-resistant Staphylococcus aureus who achieve target AUC/MIC ≥ 400. This target is often extrapolated to pediatric patients despite the lack of similar evidence. The impracticalities of calculating the AUC in practice means vancomycin trough concentrations are used to predict the AUC/MIC...
January 17, 2018: Paediatric Drugs
https://www.readbyqxmd.com/read/29319843/prediction-of-vancomycin-dose-for-recommended-trough-concentrations-in-pediatric-patients-with-cystic-fibrosis
#2
Raid W Amin, Rodney P Guttmann, Quianna R Harris, Janesha W Thomas
Vancomycin is a key antibiotic used in the treatment of multiple conditions including infections associated with cystic fibrosis and methicillin-resistant Staphylococcus aureus. The present study sought to develop a model based on empirical evidence of optimal vancomycin dose as judged by clinical observations that could accelerate the achievement of desired trough level in children with cystic fibrosis. Transformations of dose and trough were used to arrive at regression models with excellent fit for dose based on weight or age for a target trough...
January 10, 2018: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29290740/vancomycin-dosing-and-monitoring-in-the-treatment-of-cystic-fibrosis-results-of-a-national-practice-survey
#3
Rebecca S Pettit, Stacy J Peters, Erin J McDade, Kaci Kreilein, Radha Patel, Kevin Epps, Frederick Kittell, Mariela A Duval, Jeffery T Zobell
OBJECTIVES: Vancomycin is commonly used in patients with cystic fibrosis (CF) to treat acute pulmonary exacerbations, but few guidelines exist to help dose and monitor patients. The objective of this study was to assess vancomycin use and monitoring strategies at Cystic Fibrosis Foundation (CFF)-accredited centers in hopes of developing and implementing vancomycin dosing and monitoring standards. METHODS: An anonymous national cross-sectional survey of pharmacists affiliated with CFF-accredited pediatric and/or adult centers was performed by using Surveymonkey...
November 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29280786/nephrotoxicity-with-vancomycin-in-the-pediatric-population-a-systematic-review-and-meta-analysis
#4
Theresa M Fiorito, Megan K Luther, Penelope H Dennehy, Kerry L LaPlante, Kelly L Matson
BACKGROUND: Vancomycin is frequently used to treat methicillin-resistant Staphylococcus aureus (MRSA) infections in pediatric patients. Vancomycin exposure may lead to an increase in frequency of nephrotoxicity. Our aim was to conduct a systematic review to describe predictors of nephrotoxicity associated with vancomycin, including documented trough concentrations ≥15mg/L. We also aimed to use a meta-analysis to assess the impact of a vancomycin trough ≥15 mg/L on nephrotoxicity...
December 26, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29260505/vancomycin-dosing-and-monitoring-critical-evaluation-of-the-current-practice
#5
Fawzy Elbarbry
After more than six decades of its use as the mainstay antibiotic for the treatment of multidrug-resistant Gram-positive bacterial infections, dosing and monitoring of vancomycin therapy have not been optimized. The current vancomycin therapeutic guidelines recommend empiric doses of 15-20 mg/kg administered by intermittent infusion every 8-12 h in patients with normal kidney function. Additionally, the guidelines recommend trough concentration of 15-20 mg/L as a therapeutic goal for adult patients with severe infections...
December 19, 2017: European Journal of Drug Metabolism and Pharmacokinetics
https://www.readbyqxmd.com/read/29203493/a-prospective-trial-on-the-use-of-trough-concentration-versus-area-under-the-curve-auc-to-determine-therapeutic-vancomycin-dosing
#6
Michael N Neely, Lauren Kato, Gilmer Youn, Lironn Kraler, David Bayard, Michael van Guilder, Alan Schumitzky, Walter Yamada, Brenda Jones, Emi Minejima
We hypothesized that dosing vancomycin to achieve trough concentrations >15 mg/L overdoses many adults compared to AUC-guided dosing. We conducted a 3-year, prospective study of vancomycin dosing, plasma concentrations, and outcomes. In year 1, non-study clinicians targeted trough concentrations of 10-20 mg/L (infection dependent) and controlled dosing. In years 2 and 3, the study team controlled vancomycin dosing with the BestDose Bayesian software to achieve a daily, steady-state AUC:MIC≥400, with maximum AUC 800 mg*h/L, regardless of trough concentration...
December 4, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29169279/evaluation-of-intravenous-vancomycin-pharmacokinetic-parameters-in-patients-with-acute-brain-injury
#7
Allison Oswalt, Anny-Claude Joseph, Adam Sima, Lisa Kurczewski
BACKGROUND: Vancomycin is a glycopeptide antibiotic that is primarily cleared by renal elimination. Patients with acute brain injury often exhibit augmented renal clearance which has been associated with subtherapeutic vancomycin concentrations. OBJECTIVE: To determine whether population pharmacokinetics accurately predict vancomycin empiric dose frequency in patients with acute brain injury. METHODS: This was a single-center, retrospective cohort study conducted following institutional review board approval at Virginia Commonwealth University Health System...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29109576/baseline-competency-assessment-of-pharmacists-prescribing-and-managing-vancomycin-therapy-in-the-regina-qu-appelle-health-region
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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...
December 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
#20
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
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