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vancomycin trough

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https://www.readbyqxmd.com/read/28099635/currently-used-dosage-regimens-of-vancomycin-fail-to-achieve-therapeutic-levels-in-approximately-40-of-intensive-care-unit-patients
#1
Vitor Yuzo Obara, Carolina Petrus Zacas, Claudia Maria Dantas de Maio Carrilho, Vinicius Daher Alvares Delfino
Objective: This study aimed to assess whether currently used dosages of vancomycin for treatment of serious gram-positive bacterial infections in intensive care unit patients provided initial therapeutic vancomycin trough levels and to examine possible factors associated with the presence of adequate initial vancomycin trough levels in these patients. Methods: A prospective descriptive study with convenience sampling was performed. Nursing note and medical record data were collected from September 2013 to July 2014 for patients who met inclusion criteria...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28096158/vancomycin-area-under-the-curve-estimation-in-obese-adults-the-peak-improves-precision-and-lowers-bias
#2
Manjunath P Pai, Joseph Hong, Lynne Krop
Vancomycin area under the curve (AUC) estimates may be skewed in obese adults due to weight-dependent pharmacokinetic parameters. We demonstrate that peak and trough measurements reduce bias and improve the precision of vancomycin AUC estimates in obese adults (n=75) and validate this in an independent cohort (n=31). The precision and mean %bias of Bayesian vancomycin AUC estimates are comparable between covariate-dependent (R(2)=0.774, 3.55%) and covariate-independent (R(2)=0.804, 3.28%) models when peaks and troughs are measured but not when restricted to trough only measurements (R(2),= 0...
January 17, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28027279/the-influence-of-the-route-of-antibiotic-administration-methicillin-susceptibility-vancomycin-duration-and-serum-trough-concentration-on-outcomes-of-pediatric-staphylococcus-aureus-bacteremic-osteoarticular-infection
#3
J Chase McNeil, Sheldon L Kaplan, Jesus G Vallejo
BACKGROUND: Bacteremia is often one factor used in deciding the need for prolonged intravenous antimicrobial therapy in osteoarticular infections (OAI). We examined treatment practices and outcomes of bacteremic S. aureus osteoarticular infections (BOAI) evaluated at Texas Children's Hospital (TCH). METHODS: Cases of acute hematogenous OAI in children with positive blood cultures for S. aureus at TCH from 2011-2014 were reviewed. Orthopedic complications included chronic osteomyelitis, growth arrest, pathologic fracture, avascular necrosis and chronic dislocation...
December 23, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28025029/neutropenia-is-independently-associated-with-sub-therapeutic-serum-concentration-of-vancomycin
#4
Min Hyuk Choi, Yeon Hwa Choe, Sang-Guk Lee, Seok Hoon Jeong, Jeong-Ho Kim
BACKGROUND: We aimed to identify the impact of the presence of neutropenia on serum vancomycin concentration (SVC). METHODS: A retrospective study was conducted from January 2005 to December 2015. The study population was comprised of adult patients who were performed serum concentration of vancomycin. Patients with renal failure or using non-conventional dosages of vancomycin were excluded. RESULTS: A total of 1307 adult patients were included in this study, of whom 163 (12...
December 23, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28018150/frequency-of-and-risk-factors-for-acute-kidney-injury-associated-with-vancomycin-use-in-the-pediatric-intensive-care-unit
#5
Sarah Bonazza, Lauren C Bresee, Timothy Kraft, B Catherine Ross, Deonne Dersch-Mills
BACKGROUND: Published information evaluating frequency of and risk factors for vancomycin-induced acute kidney injury (AKI) in the pediatric intensive care unit (PICU) population is conflicting. OBJECTIVES: The primary objective was to describe the proportion of our PICU patients who developed AKI with intravenous (IV) vancomycin. The secondary objective was to describe the associated potential risk factors. METHODS: Pediatric patients (0-18 years) who received their first IV vancomycin dose in the PICU were evaluated in this retrospective chart review...
November 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28017667/assessment-of-optimal-initial-dosing-regimen-with-vancomycin-pharmacokinetics-model-in-very-low-birth-weight-neonates
#6
Hideo Kato, Mao Hagihara, Naoya Nishiyama, Yusuke Koizumi, Hiroshige Mikamo, Katsuhiko Matsuura, Yuka Yamagishi
INTRODUCTION: Pharmacokinetic of vancomycin in very low birth weight neonates showed big variety, and limited data were available due to very minor population. These facts make it difficult to adjust its optimal initial dosage. Therefore, this study was to develop optimal dosing regimen of vancomycin in very low birth weight neonates. METHODS: Between 2010 and 2015, low birth weight neonates (≤1500 g) were included in a population pharmacokinetics analysis. Based on the pharmacokinetic parameters we estimated, we simulated individual blood concentrations of vancomycin and evaluated the probability of its pharmacokinetics/pharmacodynamics (PK/PD) target attainment, such as 24-h area under the concentration-time curve (AUC24)/MIC (≥400) and blood trough concentration (10-20 μg/mL), as primary measure for several dosing regimens by Monte Carlo simulation method...
December 22, 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28006894/evaluation-of-clinical-outcome-in-children-and-adolescents-receiving-vancomycin-for-invasive-infections-due-to-methicillin-resistant-staphylococcus-aureus-impact-of-increasing-vancomycin-mics
#7
Aparna Arun, Siddharth Swamy, Kathleen Jacob, Roopali Sharma, Stephan A Kohlhoff, Margaret R Hammerschlag
BACKGROUND: Vancomycin is the preferred drug for the treatment of MRSA infections in children. In adults, treatment failure with vancomycin has been associated with an area under the curve/24 hrs /MIC (AUC24/MIC) ratio of < 400 and high minimum inhibitory concentrations (MIC > 1.0 mg/L). Vancomycin dosing information to ensure optimal AUC24/MIC in the pediatric population remains limited. METHODS: A retrospective chart review from August 2008 to 2011 and a prospective study from September 2011 to October 2013 was conducted on all pediatric patients at two hospitals in Brooklyn, NY with positive cultures for MRSA who received vancomycin...
December 22, 2016: Minerva Pediatrica
https://www.readbyqxmd.com/read/27999035/impact-of-vancomycin-protein-binding-on-target-attainment-in-critically-ill-children-back-to-the-drawing-board
#8
Pieter A J G De Cock, Sarah Desmet, Annick De Jaeger, Dominique Biarent, Evelyn Dhont, Ingrid Herck, Daphné Vens, Sofie Colman, Veronique Stove, Sabrina Commeyne, Johan Vande Walle, Peter De Paepe
OBJECTIVES: The objectives of this observational study were to investigate plasma protein binding and to evaluate target attainment rates of vancomycin therapy in critically ill children. PATIENTS AND METHODS: Paediatric ICU patients, in whom intravenous intermittent dosing (ID) or continuous dosing (CD) with vancomycin was indicated, were included. Covariates on unbound vancomycin fraction and concentration were tested using a linear mixed model analysis and attainment of currently used pharmacokinetic/pharmacodynamic (PK/PD) targets was evaluated...
December 20, 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27931193/coagulase-negative-staphylococcal-sepsis-in-neonates-do-we-need-to-adapt-vancomycin-dose-or-target
#9
Helgi Padari, Kersti Oselin, Tõnis Tasa, Tuuli Metsvaht, Krista Lõivukene, Irja Lutsar
BACKGROUND: Despite differences in types of infection and causative organisms, pharmacokinetic-pharmacodynamic (PKPD) targets of vancomycin therapy derived from adult studies are suggested for neonates. We aimed to identify doses needed for the attainment of AUC/MIC > 400 and AUC/MIC > 300 in neonates with sepsis and correlate these targets with recommended doses and treatment outcome. METHODS: Neonates who had Vancomycin therapeutic drug monitoring (TDM) performed between January 1, 2010 and December 31, 2012 were studied...
December 8, 2016: BMC Pediatrics
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
#10
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
#11
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
#12
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 vancomycin was performed...
February 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/27836495/duration-of-systemic-inflammatory-response-syndrome-influences-serum-vancomycin-concentration-in-patients-with-sepsis
#13
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...
December 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
#14
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
#15
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
#16
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
#17
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
#18
William M Bennett
No abstract text is available yet for this article.
2016: American Journal of Nephrology
https://www.readbyqxmd.com/read/27756193/evaluation-of-weight-based-vancomycin-dosing-for-hospitalized-hemodialysis-patients
#19
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...
November 2016: Renal Failure
https://www.readbyqxmd.com/read/27729678/evaluation-of-the-safety-of-a-vancomycin-nomogram-used-to-achieve-target-trough-concentrations
#20
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
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