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vancomycin trough

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https://www.readbyqxmd.com/read/28406088/population-pharmacokinetics-of-vancomycin-in%C3%A2-chinese-infants%C3%A2
#1
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
#2
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
#3
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
#4
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
#5
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/evaluation-of-a-bayesian-approach-to-estimate-vancomycin-exposure-in-obese-patients-with-limited-pharmacokinetic-sampling-a-pilot-study
#6
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-hour vancomycin area under the curve estimation (AUC) with limited PK sampling in adult obese patients receiving vancomycin for suspected or confirmed Gram-positive infections. This was an IRB-approved prospective evaluation of 12 patients. Patients had a median (95% CI) age of 61 years (39 - 71), creatinine clearance of 86 mL/min (75 - 120), and body mass index of 45 kg/m(2) (40 - 52). For each patient, five PK concentrations were measured and 4 different vancomycin population PK models were used as Bayesian priors to estimate the estimate vancomycin AUC (AUCFULL)...
March 13, 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
#7
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/towards-individualised-vancomycin-dosing-in-methicillin-resistant-staphylococcus-aureus-bacteraemia-establishment-of-an-auc0-24-threshold-for-nephrotoxicity
#8
R Chavada, N Ghosh, I Sandaradura, M Maley, S J Van Hal
Background: Unlike vancomycin trough concentrations, data on the utility of vancomycin pharmacokinetic (PK) parameters, namely the 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 bacteraemia (MRSA-B).Methods: A single centre retrospective observational cohort study involving 127 consecutive MRSA-B patients was conducted to examine the incidence of AKI, (defined as serum creatinine ≥0...
February 27, 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
#9
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
#10
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
#11
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...
January 25, 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
#12
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
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
#13
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/peak-measurement-for-vancomycin-auc-estimation-in-obese-adults-improves-precision-and-lowers-bias
#14
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 percent 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 measurements are restricted to troughs only (R(2) = 0...
April 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
#15
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
#16
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...
February 2017: 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
#17
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
#18
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
#19
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
#20
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...
March 1, 2017: Journal of Antimicrobial Chemotherapy
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