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vancomycin trough

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https://www.readbyqxmd.com/read/27914127/impact-of-initial-vancomycin-trough-concentration-on-clinical-and-microbiological-outcomes-of-methicillin-resistant-staphylococcus-aureus-bacteremia-in-children
#1
Ree Nar Yoo, Seo Hee Kim, Jina Lee
It is important to use vancomycin in a proper manner to ensure optimal drug exposure. Despite extensive use of vancomycin in children, studies on its optimal trough concentration (Ctrough) in the pediatric population remained rare. This retrospective study included children < 18 years old with culture-confirmed methicillin-resistant Staphylococcus aureus (MRSA) bacteremia who were hospitalized in our institute from January 2010 to April 2014. Clinical characteristics, initial vancomycin dose, Ctrough and clinical/microbiological outcomes were retrospectively collected from medical records...
January 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27873214/risk-factors-for-non-therapeutic-initial-steady-state-vancomycin-trough-concentrations-in-children-and-adolescents-receiving-high-empiric-doses-of-intravenous-vancomycin
#2
Whitney R Buckel, Shahira Ghobrial, Pranita D Tamma, Aaron M Milstone, Yuan Zhao, Alice J Hsu
BACKGROUND: Achieving vancomycin troughs of 15-20 μg/mL remains challenging in children. Our objective was to identify risk factors associated with non-therapeutic initial vancomycin troughs in children. METHODS: We conducted a retrospective cohort study of children who received intravenous vancomycin with at least one initial steady-state trough obtained. Patients who achieved therapeutic troughs (15-20 μg/mL in the 20-mg/kg/dose sub-cohort and 10-15 μg/mL in the 15-mg/kg/dose sub-cohort) were compared with those with subtherapeutic troughs (<15 and <10 μg/mL, respectively) and supratherapeutic troughs (>20 and >15 μg/mL, respectively) separately to determine risk factors associated with non-therapeutic troughs...
November 21, 2016: Paediatric Drugs
https://www.readbyqxmd.com/read/27861313/is-trough-concentration-of-vancomycin-predictive-of-the-area-under-the-curve-a-clinical-study-in-elderly-patients
#3
Anis Bel Kamel, Laurent Bourguignon, Micaela Marcos, Michel Ducher, Sylvain Goutelle
BACKGROUND: Current guidelines suggest that vancomycin trough concentrations (Cmin) between 15 and 20 mg/L should be achieved to optimize vancomycin exposure and effect. The objective of this study was to analyze the correlation between vancomycin Cmin and the area under the concentration-time curve (AUC) and assess the ability to predict an AUC target of 400 mg·h/L based on Cmin. METHODS: A retrospective analysis of vancomycin therapeutic drug monitoring data collected in 95 elderly patients treated with intermittent intravenous (IV) vancomycin was performed...
November 17, 2016: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/27836495/duration-of-systemic-inflammatory-response-syndrome-influences-serum-vancomycin-concentration-in-patients-with-sepsis
#4
Masayuki Chuma, Makoto Makishima, Toru Imai, Naohiro Tochikura, Takako Sakaue, Norikazu Kikuchi, Kosaku Kinoshita, Morio Kaburaki, Yoshikazu Yoshida
PURPOSE: Vancomycin (VCM) is used in the treatment of methicillin-resistant Staphylococcus aureus infection. The dosage of VCM must be adjusted by using therapeutic drug monitoring because of the drug's narrow therapeutic concentration window. Although optimal administration based on population pharmacokinetic (PPK) analysis and/or a Bayesian method has improved prediction accuracy, serum concentrations of VCM in patients with sepsis often deviate significantly from predicted values. We investigated factors influencing prediction errors with PPK analysis in VCM dosing...
November 8, 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27809799/teicoplanin-based-antimicrobial-therapy-in-staphylococcus-aureus-bone-and-joint-infection-tolerance-efficacy-and-experience-with-subcutaneous-administration
#5
Olivier Peeters, Tristan Ferry, Florence Ader, André Boibieux, Evelyne Braun, Anissa Bouaziz, Judith Karsenty, Emmanuel Forestier, Frédéric Laurent, Sébastien Lustig, Christian Chidiac, Florent Valour
BACKGROUND: Staphylococci represent the first etiologic agents of bone and joint infection (BJI), leading glycopeptides use, especially in case of methicillin-resistance or betalactam intolerance. Teicoplanin may represent an alternative to vancomycin because of its acceptable bone penetration and possible subcutaneous administration. METHODS: Adults receiving teicoplanin for S. aureus BJI were included in a retrospective cohort study investigating intravenous or subcutaneous teicoplanin safety and pharmacokinetics...
November 3, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27803487/improvement-of-predictivity-of-teicoplanin-serum-trough-concentrations-at-steady-state-calculated-by-vancomycin-pharmacokinetic-parameter
#6
Ryo Kobayashi, Shinya Otomo, Yusuke Shiba, Keiichi Ebinuma, Toshiaki Sudoh
 According to a recent study and meta-analysis, trough levels of >10 μg/mL teicoplanin (TEIC) may be acceptable for the treatment of uncomplicated infection, but no method of TEIC personalized medicine has been established. Vancomycin (VCM) and TEIC are glycopeptide antibiotic agents effective against methicillin-resistance Staphyloccocus aureus. This study aimed to establish TEIC personalized medicine at a steady state calculated by VCM pharmacokinetic parameters. Bayesian forecasting and population mean methods were employed to estimate individual total VCM clearance (CL) using existing population pharmacokinetics (PPK) parameter, and the differences between the CL calculated by these two methods were defined as ΔCL...
2016: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/27789965/pharmacist-managed-dose-adjustment-feedback-using-therapeutic-drug-monitoring-of-vancomycin-was-useful-for-patients-with-methicillin-resistant-staphylococcus-aureus-infections-a-single-institution-experience
#7
Ryuichi Hirano, Yuichi Sakamoto, Junichi Kitazawa, Shoji Yamamoto, Naoki Tachibana
BACKGROUND: Vancomycin (VCM) requires dose adjustment based on therapeutic drug monitoring. At Aomori Prefectural Central Hospital, physicians carried out VCM therapeutic drug monitoring based on their experience, because pharmacists did not participate in the dose adjustment. We evaluated the impact of an Antimicrobial Stewardship Program (ASP) on attaining target VCM trough concentrations and pharmacokinetics (PK)/pharmacodynamics (PD) parameters in patients with methicillin-resistant Staphylococcus aureus (MRSA) infections...
2016: Infection and Drug Resistance
https://www.readbyqxmd.com/read/27788522/vancomycin-trough-and-acute-kidney-injury-a-large-retrospective-cohort-study
#8
Kassem Hammoud, Michael Brimacombe, Alan Yu, Neil Goodloe, Wael Haidar, Wissam El Atrouni
BACKGROUND: The association between vancomycin trough (VT) and acute kidney injury (AKI) at the recommended doses remains controversial. METHODS: The authors conducted a retrospective, observational cohort study of 500 adult patients who received vancomycin for ≥72 h. Data collected included 2 main predictors: average VT (including only VTs before the occurrence of AKI), first VT and other possible risk factors for AKI. The baseline characteristics/variables between patients with AKI and patients with no AKI were compared...
2016: American Journal of Nephrology
https://www.readbyqxmd.com/read/27788507/vancomycin-trough-levels-cause-or-result-of-acute-kidney-injury
#9
William M Bennett
No abstract text is available yet for this article.
October 28, 2016: American Journal of Nephrology
https://www.readbyqxmd.com/read/27756193/evaluation-of-weight-based-vancomycin-dosing-for-hospitalized-hemodialysis-patients
#10
Rebecca Maxson, Julia Pate, Jessica Starr
BACKGROUND: Current vancomycin dosing guidelines recommend targeting trough concentrations of 15-20 mg/L in complicated infections to avoid treatment failure and resistance. How to accomplish this in the intermittent hemodialysis (IHD) population has not been adequately described. A weight-based vancomycin dosing protocol for IHD patients was developed to provide standardization of vancomycin dosing for this patient population. Prior to implementation of this protocol, clinical pharmacists used their individual judgment for dosing and monitoring...
October 19, 2016: Renal Failure
https://www.readbyqxmd.com/read/27729678/evaluation-of-the-safety-of-a-vancomycin-nomogram-used-to-achieve-target-trough-concentrations
#11
EDITORIAL
Kristen A O'Brien, Steve Mok
BACKGROUND: Dosing vancomycin to achieve target concentrations of 15 to 20 mg/L has been recommended for select infections. To date, few vancomycin nomograms designed to target these higher concentrations have been published, and only one has been published in North America. Based on the success of this nomogram in developing empiric vancomycin regimens that achieve higher target trough concentrations with low rates of nephrotoxicity, a vancomycin nomogram targeting concentrations of 15 to 20 mg/L was developed and implemented at Emory University Hospital and Emory University Hospital Midtown...
November 2015: Hospital Pharmacy
https://www.readbyqxmd.com/read/27713673/does-combination-therapy-with-vancomycin-and-piperacillin-tazobactam-increase-the-risk-of-nephrotoxicity-versus-vancomycin-alone-in-pediatric-patients
#12
Katherine E McQueen, Dana W Clark
OBJECTIVES: To determine if the incidence of nephrotoxicity is higher in pediatric patients treated with the combination of vancomycin and piperacillin-tazobactam, compared to patients treated with vancomycin alone. Secondary objectives were to determine if admission to an intensive care unit (ICU), higher serum vancomycin trough concentrations (>15 mg/L), or receipt of other nephrotoxic agents were related to the development of nephrotoxicity. METHODS: This was a retrospective, single-center, cohort study of 79 patients treated with vancomycin and 106 patients treated with vancomycin and pipracillin/tazobacatam (TZP)...
July 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/27686168/the-safety-and-efficacy-of-high-versus-low-vancomycin-trough-levels-in-the-treatment-of-patients-with-infections-caused-by-methicillin-resistant-staphylococcus-aureus-a-meta-analysis
#13
Sasima Tongsai, Pornpan Koomanachai
BACKGROUND: Recent guidelines have recommended vancomycin trough levels of 15-20 mg/L for treatment of serious infections caused by methicillin-resistant Staphylococcus aureus (MRSA). However, high trough levels may increase risk of nephrotoxicity and mortality, and high vancomycin trough levels have not been well studied. This study was designed to combine safety and efficacy results from independent studies and to compare between high and low vancomycin trough levels in the treatment of MRSA-infected patients using meta-analysis...
September 29, 2016: BMC Research Notes
https://www.readbyqxmd.com/read/27681114/augmented-renal-clearance-in-patients-with-febrile-neutropenia-is-associated-with-increased-risk-for-subtherapeutic-concentrations-of-vancomycin
#14
Keita Hirai, Hidetoshi Ishii, Takayuki Shimoshikiryo, Tatsuki Shimomura, Daiki Tsuji, Kazuyuki Inoue, Toshihiko Kadoiri, Kunihiko Itoh
BACKGROUND: Augmented renal clearance (ARC) has frequently been observed in critically ill patients. The risk factors for ARC in patients, including those in the general ward, and their influences on vancomycin (VCM) treatment remain unclear. The aims of this study were to investigate the risk factors for ARC and to evaluate the influence of ARC on the pharmacokinetic parameters of VCM. METHODS: This study included a total of 292 patients with VCM treatment who had normal serum creatinine concentrations...
December 2016: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/27646196/a-pharmacokinetic-approach-to-calculate-the-time-to-delay-the-next-vancomycin-dose-after-a-supratherapeutic-trough
#15
EDITORIAL
Loren Trager
No abstract text is available yet for this article.
October 2016: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/27639260/a-population-pharmacokinetic-model-for-vancomycin-in-adult-patients-receiving-extracorporeal-membrane-oxygenation-therapy
#16
J N Moore, J R Healy, B N Thoma, M M Peahota, M Ahamadi, L Schmidt, N C Cavarocchi, W K Kraft
The literature on the pharmacokinetics of vancomycin in patients undergoing extracorporeal membrane oxygenation (ECMO) therapy is sparse. A population pharmacokinetic (PK) model for vancomycin in ECMO patients was developed using a nonlinear mixed effects modeling on the concentration-time profiles of 14 ECMO patients who received intravenous vancomycin. Model selection was based on log-likelihood criterion, goodness of fit plots, and scientific plausibility. Identification of covariates was done using a full covariate model approach...
September 2016: CPT: Pharmacometrics & Systems Pharmacology
https://www.readbyqxmd.com/read/27636875/impact-of-a-pharmacist-initiated-vancomycin-monitoring-program
#17
Andrew P Smith, Catherine A Millares-Sipin, Marian James, Henry Cohen
OBJECTIVES: Evaluate the clinical impact of pharmacist-initiated vancomycin monitoring and dosing in a long-term care setting. DESIGN: Single-center, pretest, post-test design. SETTING: Rutland Nursing Home, Brooklyn, New York. PARTICIPANTS: Nursing facility residents treated with intravenous vancomycin (N = 198). OUTCOME MEASURES: The primary objective is to determine the incidence of acute kidney injury (AKI) a year before and a year after implementation of a pharmacist-initiated vancomycin-monitoring protocol...
September 2016: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/27635396/different-vancomycin-immunoassays-contribute-to-the-variability-in-vancomycin-trough-measurements-in-neonates
#18
Janko Samardzic, Anne Smits, Isabel Spriet, Ivan Soldatovic, Andrew Atkinson, Milica Bajcetic, John N Van Den Anker, Karel Allegaert
Substantial interassay variability (up to 20%) has been described for vancomycin immunoassays in adults, but the impact of neonatal matrix is difficult to quantify because of blood volume constraints in neonates. However, we provide circumstantial evidence for a similar extent of variability. Using the same vancomycin dosing regimens and confirming similarity in clinical characteristics, vancomycin trough concentrations measured by PETINIA (2011-2012, n = 400) were 20% lower and the mean difference was 1.93 mg/L compared to COBAS (2012-2014, n = 352) measurements...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27610175/a-prospective-study-to-assess-vancomycin-serum-concentrations-inpediatric-patients-with-current-dosing-guidelines
#19
Peyman Arfa, Abdollah Karimi, Sedigheh Rafiei Tabatabaei, Alireza Fahimzad, Shahnaz Armin, Mohammad Sistanizad
Concerns about increasing bacterial resistance to vancomycin, have caused the adult treatment guidelines to recommend higher trough concentrations based on the type and location of infectious disease. Although these recommendations are not specific to children, the values can be extrapolated. This prospective study was designed to evaluate efficacy of current vancomycin dosing recommendations to achieve therapeutic trough serum concentration in pediatric patients. Laboratory data, vancomycin dosing and subsequent serum concentrations of children in a community teaching pediatrics hospital were collected and analyzed...
2016: Iranian Journal of Pharmaceutical Research: IJPR
https://www.readbyqxmd.com/read/27596084/-clinical-efficacy-and-safety-of-vancomycin-compared-with-linezolid-for-the-treatment-of-neonatal-gram-positive-bacterial-sepsis
#20
L Tang, J Fang, S N Wang, X H Weng, J J Li, E N Shang
OBJECTIVE: To evaluate the clinical efficacy and safety of vancomycin and linezolid for the treatment of gram-positive neonatal bacterial sepsis. METHOD: The data of neonates diagnosed as gram-positive bacterial sepsis in neonatology department of Suzhou Municipal Hospital from June 2009 to December 2015 were retrospectively collected. These neonates were divided into vancomycin group and linezolid group. Propensity score matching (PSM) on baseline variables was used to balance the two groups by identifying a comparable group of neonates who received vancomycin and linezolid therapy...
September 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
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