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vancomycin trough

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https://www.readbyqxmd.com/read/28640009/augmented-renal-clearance-using-population-based-pharmacokinetic-modeling-in-critically-ill-pediatric-patients
#1
Sean N Avedissian, Erin Bradley, Diana Zhang, John S Bradley, Lama H Nazer, Tri M Tran, Austin Nguyen, Jennifer Le
OBJECTIVES: The objectives of this study were to: 1) evaluate the prevalence of augmented renal clearance in critically ill pediatric patients using vancomycin clearance; 2) derive the pharmacokinetic model that best describes vancomycin clearance in critically ill pediatric patients; and 3) correlate vancomycin clearance with creatinine clearance estimated by modified Schwartz or Cockcroft-Gault. DESIGN: Retrospective, two-center, cohort study from 2003 to 2016...
June 20, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28627271/vancomycin-trough-concentration-poorly-characterizes-auc-is-it-time-to-transition-to-auc-based-vancomycin-monitoring
#2
Robert W Seabury, Andrew M Stoessel, Jeffrey M Steele
No abstract text is available yet for this article.
June 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28625235/-pharmacokinetics-of-vancomycin-in-patients-with-severe-acute-pancreatitis-and-its-influencing-factors-analysis-of-7-years-data
#3
Juan He, Enqiang Mao, Feng Jing, Huiting Jiang, Wanhua Yang, Erzhen Chen
OBJECTIVE: To observe the change of the serum trough concentration and its pharmacokinetics of vancomycin in patients with severe acute pancreatitis (SAP), and to analyze the factors influencing vancomycin concentration. METHODS: A retrospective analysis was conducted. Steady-state trough concentrations of vancomycin from patients (18-80 years old) with SAP concomitantly with G(+) infection admitted to Intensive Care Unit (ICU) of Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2010 to December 2016 were enrolled...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28607023/pharmacokinetic-assessment-of-vancomycin-loading-dose-in-critically-ill-patients
#4
Osvaldo Álvarez, Jose Cristian Plaza-Plaza, Manuel Ramirez, Alexis Peralta, Cristián A Amador, Roberto Amador
Background: The vancomycin loading dose (LD) of 25-30 mg/kg is a frequently practiced strategy to achieve effective concentrations from the first-treatment dose. However, considering only the body weight for dosing might be inadequate in critically ill patients due to pharmacokinetics changes.Objective: Assess achieving optimal trough serum levels of vancomycin and AUC0-24/MIC in the first 24-hours of treatment, by using a LD based on population pharmacokinetic parameters of critically ill patients.Methods: We performed a concurrent cohort study over 22 months of patients with severe sepsis who received intravenous vancomycin...
June 12, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28573434/the-whole-price-of-vancomycin-toxicities-troughs-and-time
#5
Meghan N Jeffres
Vancomycin is a glycopeptide antibiotic that is active against Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus. Nephrotoxicity, which is usually reversible, is the most serious common adverse effect of vancomycin. Vancomycin-associated nephrotoxicity prolongs hospital stays, imposes a need for additional antibiotics and, in rare circumstances, dialysis treatment, and increases medical costs and mortality. Risk factors for nephrotoxicity include the dose and duration of vancomycin treatment, serum trough concentration, patient characteristics, and concomitant receipt of nephrotoxins...
June 1, 2017: Drugs
https://www.readbyqxmd.com/read/28562284/epidemiology-of-methicillin-resistant-staphylococcus-aureus-bacteremia-in-children
#6
Rana F Hamdy, Alice J Hsu, Chris Stockmann, Jared A Olson, Matthew Bryan, Adam L Hersh, Pranita D Tamma, Jeffrey S Gerber
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia is associated with high rates of treatment failure in adults. The epidemiology, clinical outcomes, and risk factors for treatment failure associated with MRSA bacteremia in children are poorly understood. METHODS: Multicenter, retrospective cohort study of children ≤18 years hospitalized with MRSA bacteremia across 3 tertiary care children's hospitals from 2007 to 2014. Treatment failure was defined as persistent bacteremia >3 days, recurrence of bacteremia within 30 days, or attributable 30-day mortality...
May 5, 2017: Pediatrics
https://www.readbyqxmd.com/read/28562258/the-impact-of-pediatric-specific-vancomycin-dosing-guidelines-a-quality-improvement-initiative
#7
Molly Miloslavsky, Marjorie F Galler, Iman Moawad, Janet Actis, Brian M Cummings, Chadi M El Saleeby
BACKGROUND AND OBJECTIVES: There are limited data guiding vancomycin dosing practices in the pediatric population to target the goal troughs recommended by national vancomycin guidelines. In this study, we sought to improve adherence to guideline trough targets through a quality improvement intervention. METHODS: A retrospective analysis was first conducted to assess baseline performance. A multidisciplinary team then developed and implemented a standardized dosing algorithm recommending 15 mg/kg per dose for mild and moderate infections (goal trough: 10-15 µg/mL) and 20 mg/kg per dose for severe infections (goal trough: 15-20 µg/mL), both delivered every 6 hours (maximum single dose: 750 mg)...
May 11, 2017: Pediatrics
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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