Augmented Renal Clearance of Vancomycin in Hematologic Malignancy Patients
| Autor: | Tomohiro Izumisawa, Tetsuya Horino, Tomoyoshi Kaneko, Masakazu Soma, Noriko Takahashi, Masahiko Imai, Hideo Hasegawa, Nobuyuki Wakui |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male 0301 basic medicine medicine.medical_specialty Metabolic Clearance Rate Pharmaceutical Science Gastroenterology 03 medical and health sciences 0302 clinical medicine Japan Pharmacokinetics Vancomycin Internal medicine medicine Hematologic malignancy Humans In patient Aged Retrospective Studies Aged 80 and over Pharmacology business.industry Confounding General Medicine Middle Aged Anti-Bacterial Agents Resistant bacteria 030104 developmental biology Hematologic Neoplasms 030220 oncology & carcinogenesis Propensity score matching Female Drug Monitoring business medicine.drug Clearance |
| Zdroj: | Biological and Pharmaceutical Bulletin. 42:2089-2094 |
| ISSN: | 1347-5215 0918-6158 |
| DOI: | 10.1248/bpb.b19-00652 |
| Popis: | The pharmacokinetics of vancomycin (VAN) was retrospectively examined based on trough concentrations at large scale to identify pharmacokinetic differences between Japanese hematologic malignancy and non-malignancy patients. Data from 261 hematologic malignancy patients and 261 non-malignancy patients, including the patient's background, VAN dose, and pharmacokinetics of VAN estimated by an empirical Bayesian method, were collected and analyzed. Our results showed significantly higher values for VAN clearance and shorter elimination half-lives in patients with hematologic malignancies than non-malignancy patients. In addition, multiple regression analysis under adjusting for confounding factors by propensity score, showed that VAN clearance significantly increased in relation to hematologic malignancies. In conclusion, since in hematologic cancer patients VAN clearance is increased, the blood concentration of VAN becomes lower than expected and this may contribute to the survival of resistant bacteria when VAN is administered at low doses. These results suggest that early monitoring of VAN levels in hematologic cancer patients might be recommended to maintain desired effects without side-effects. |
| Databáze: | OpenAIRE |
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