Initial dosing regimen of vancomycin to achieve early therapeutic plasma concentration in critically ill patients with MRSA infection based on APACHE II score

Autor: Haruko Yokoyama, Hiroshi Kanno, Masaharu Imaura, Hiroyuki Takahashi, Yasuhiko Yamada, Yuichi Maki, Yuji Kohata, Wataru Idemitsu, Tomoki Kohyama, Riichiro Kanai, Takashi Igarashi
Rok vydání: 2014
Předmět:
Zdroj: European Journal of Drug Metabolism and Pharmacokinetics. 41:211-218
ISSN: 2107-0180
0378-7966
Popis: It is essential to assure the efficacy of antimicrobials at the initial phase of therapy. However, increasing the volume of distribution (Vd) of hydrophilic antimicrobials in critically ill patients leads to reduced antimicrobial concentration in plasma and tissue, which may adversely affect the efficacy of that therapy. The aim of the present study was to establish a theoretical methodology for setting an appropriate level for initial vancomycin therapy in individual patients based on Acute Physiology and Chronic Health Evaluation (APACHE) II score. We obtained data from patients who received intravenous vancomycin for a suspected or definitively diagnosed Gram-positive bacterial infection within 72 h after admission to the intensive care unit. The Vd and elimination half-life (t 1/2) of vancomycin values were calculated using the Bayesian method, and we investigated the relationship between them and APACHE II score. There were significant correlations between APACHE II scores and Vd/actual body weight (ABW), as well as t 1/2 (r = 0.58, p
Databáze: OpenAIRE
Externí odkaz: