Assessment of Therapeutic Drug Monitoring of Vancomycin in Elderly Patients According to New Guidelines
Annals of Laboratory Medicine
;
: 1-6, 2014.
Artigo
em Inglês
| WPRIM
| ID: wpr-193136
ABSTRACT
BACKGROUND:
Concerns regarding increasing microbial resistance to vancomycin have resulted in recommendations for a higher trough serum vancomycin concentration. This study aimed to assess the dosage guidelines targeting vancomycin trough concentrations of 15-20 mg/L.METHODS:
About 216 adult patients (age, >60 yr) were treated with intravenous vancomycin. The patients were divided into 2 groups according to their target vancomycin trough concentrations the previous guideline group (n=108) treated with targeted vancomycin trough concentrations of 5-15 mg/L from Jan 2009 through April 2011 and the new guideline group (n=108) treated with targeted concentrations of 15-20 mg/L from November 2011 through July 2012.RESULTS:
The 2 groups were not significantly different with respect to age, weight, initial serum creatinine, initial creatinine clearance, predictive trough levels, doses, serum drug concentrations, and area under the curve/minimal inhibitory concentrations. Regarding the proportions of vancomycin trough concentrations, the target range was achieved in 50% in the previous guideline group and in 16% in the new guideline group. In the previous and new guideline groups, the trough concentrations of 10-20 mg/dL were observed in 32.4% and 52.8% patients, respectively, and those of <10 mg/L were observed in 45.4% and 29.6%, respectively.CONCLUSIONS:
Compared to the previous guideline group, the new guideline group showed higher proportions in the therapeutic range of 10-20 mg/L and lower proportions in trough concentrations <10 mg/L. The strictly managed vancomycin therapeutic drug monitoring in the new guideline group was assessed as more effective.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Vancomicina
/
Infecções por Bactérias Gram-Positivas
/
Monitoramento de Medicamentos
/
Guias como Assunto
/
Meia-Vida
/
Injeções Intravenosas
Tipo de estudo:
Guia de Prática Clínica
/
Estudo prognóstico
Limite:
Idoso
/
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Annals of Laboratory Medicine
Ano de publicação:
2014
Tipo de documento:
Artigo
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