Importance of vancomycin loading doses in intermittent infusion regimens

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11110%2F18%3A10376460" target="_blank" >RIV/00216208:11110/18:10376460 - isvavai.cz</a>

Výsledek na webu

<a href="https://doi.org/10.1016/j.jiac.2017.11.002" target="_blank" >https://doi.org/10.1016/j.jiac.2017.11.002</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.jiac.2017.11.002" target="_blank" >10.1016/j.jiac.2017.11.002</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Importance of vancomycin loading doses in intermittent infusion regimens

Popis výsledku v původním jazyce

Purpose: Delayed achievement of target vancomycin serum concentrations may adversely affect clinical outcomes. The objective of this retrospective study was to explore the real frequency of loading dose use and to evaluate the impact of loading dose for the achievement of vancomycin PK/PD target in adult patients treated with intermittent vancomycin. As a secondary aim we determined optimal vancomycin loading dose based on individual pharmacokinetic calculations. Methods: Vancomycin pharmacokinetic models were computed using two-compartmental analysis. Based on these models AUC(24) were calculated. Unpaired t-test was used to compare AUC(24) achieved in patients treated with and without vancomycin loading dose. Results: Vancomycin loading dose was administered only in 17.8% patients. Volume of distribution and clearance median values (interquartile range) for vancomycin in whole study population (n = 45) were 0.69 (0.55-0.87) L/kg and 0.0304 (0.0217-0.0501) L/h/kg, respectively. The AUC(24) was significantly higher in patients taking loading dose compared with the group without loading dose: mean (SD) AUC(24) was 496 (101) vs. 341 (77) mg h/L. Proportion of patients reaching PK/PD goal was 87.5% and 24.3% with and without loading dose administration, respectively. Considering individual pharmacokinetic parameters optimal vancomycin loading dose was 27.5 mg/kg of body weight. Conclusions: Loading dose administration plays crucial part in rapid attainment of vancomycin PK/PD target in adult patient treated with intermittent vancomycin, although it is not frequently used in clinical practise. The optimal loading dose of 25-30 mg/kg of body weight should be routinely administered to adult patients treated with intermittent vancomycin.

Název v anglickém jazyce

Importance of vancomycin loading doses in intermittent infusion regimens

Popis výsledku anglicky

Purpose: Delayed achievement of target vancomycin serum concentrations may adversely affect clinical outcomes. The objective of this retrospective study was to explore the real frequency of loading dose use and to evaluate the impact of loading dose for the achievement of vancomycin PK/PD target in adult patients treated with intermittent vancomycin. As a secondary aim we determined optimal vancomycin loading dose based on individual pharmacokinetic calculations. Methods: Vancomycin pharmacokinetic models were computed using two-compartmental analysis. Based on these models AUC(24) were calculated. Unpaired t-test was used to compare AUC(24) achieved in patients treated with and without vancomycin loading dose. Results: Vancomycin loading dose was administered only in 17.8% patients. Volume of distribution and clearance median values (interquartile range) for vancomycin in whole study population (n = 45) were 0.69 (0.55-0.87) L/kg and 0.0304 (0.0217-0.0501) L/h/kg, respectively. The AUC(24) was significantly higher in patients taking loading dose compared with the group without loading dose: mean (SD) AUC(24) was 496 (101) vs. 341 (77) mg h/L. Proportion of patients reaching PK/PD goal was 87.5% and 24.3% with and without loading dose administration, respectively. Considering individual pharmacokinetic parameters optimal vancomycin loading dose was 27.5 mg/kg of body weight. Conclusions: Loading dose administration plays crucial part in rapid attainment of vancomycin PK/PD target in adult patient treated with intermittent vancomycin, although it is not frequently used in clinical practise. The optimal loading dose of 25-30 mg/kg of body weight should be routinely administered to adult patients treated with intermittent vancomycin.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30104 - Pharmacology and pharmacy

Projekt

—

Návaznosti

S - Specificky vyzkum na vysokych skolach<br>I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2018

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Journal of Infection and Chemotherapy

ISSN

1341-321X

e-ISSN

—

Svazek periodika

24

Číslo periodika v rámci svazku

4

Stát vydavatele periodika

NL - Nizozemsko

Počet stran výsledku

4

Strana od-do

247-250

Kód UT WoS článku

000425970600002

EID výsledku v databázi Scopus

2-s2.0-85035245697