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vancomycin trough

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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...
January 18, 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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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...
February 2017: 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
#19
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
#20
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
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