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 |
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Rok vydání: | 2014 |
Předmět: |
Adult
Male Methicillin-Resistant Staphylococcus aureus medicine.medical_specialty Critical Illness Apache II score medicine.disease_cause law.invention 03 medical and health sciences 0302 clinical medicine Vancomycin law Internal medicine medicine Humans Pharmacology (medical) 030212 general & internal medicine APACHE Aged Retrospective Studies Pharmacology Volume of distribution APACHE II business.industry Dosing regimen Bayes Theorem 030208 emergency & critical care medicine Retrospective cohort study Middle Aged Staphylococcal Infections Methicillin-resistant Staphylococcus aureus Intensive care unit Intensive Care Units Anesthesia Female business Half-Life medicine.drug |
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 |
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