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Pharmacokinetic assessment of vancomycin loading dose in critically ill patients

dc.contributor.authorÁlvarez O.
dc.contributor.authorPlaza-Plaza J.C.
dc.contributor.authorRamirez M.
dc.contributor.authorPeralta A.
dc.contributor.authorAmador C.A.
dc.contributor.authorAmador R.
dc.date.accessioned2020-09-02T22:31:05Z
dc.date.available2020-09-02T22:31:05Z
dc.date.issued2017
dc.identifier10.1128/AAC.00280-17
dc.identifier.citation61, 8, -
dc.identifier.issn00664804
dc.identifier.urihttps://hdl.handle.net/20.500.12728/6719
dc.descriptionThe vancomycin loading dose (LD) of 25 to 30 mg/kg is a frequently practiced strategy to achieve effective concentrations from the first-treatment dose. However, considering only the body weight for dosing might be inadequate in critically ill patients due to pharmacokinetics changes. We sought to assess achieving optimal trough serum levels of vancomycin and AUC0–24/MIC in the first 24 h of treatment by using an LD based on population pharmacokinetic parameters of critically ill patients. We performed a concurrent cohort study over 22 months of patients with severe sepsis who received intravenous vancomycin. The patients were treated with three different strategies to initiate vancomycin: without an LD (group A), with an LD of 25 to 30 mg/kg (group B), and with an LD based on population pharmacokinetic parameters of the critically ill patient (group C). An optimal trough serum concentration was achieved in 5, 9, and 83% of patients in groups A, B, and C, respectively. The number of patients that reached optimal AUC0–24 was 2 of 18 (11%), 5 of 11 (46%), and 11 of 12 (92%) in groups A, B, and C, respectively. The statistical analysis for both parameters revealed significant differences in group C with respect to other groups. The administration of the LD calculated from population pharmacokinetic parameters from the beginning of therapy is a more efficient strategy to obtain adequate trough serum concentrations and AUC0–24/MIC in critical patients. © 2017 American Society for Microbiology. All Rights Reserved.
dc.language.isoen
dc.publisherAmerican Society for Microbiology
dc.subjectCritical care
dc.subjectPharmacokinetics
dc.subjectVancomycin
dc.subjectcreatinine
dc.subjectvancomycin
dc.subjectantiinfective agent
dc.subjectvancomycin
dc.subjectadult
dc.subjectanalysis of variance
dc.subjectarea under the curve
dc.subjectArticle
dc.subjectbody mass
dc.subjectclinical article
dc.subjectcohort analysis
dc.subjectcontrolled study
dc.subjectcreatinine blood level
dc.subjectcritically ill patient
dc.subjectdrug blood level
dc.subjectdrug clearance
dc.subjectdrug safety
dc.subjecteffective concentration
dc.subjectfemale
dc.subjectFisher exact test
dc.subjecthuman
dc.subjectkidney function
dc.subjectloading drug dose
dc.subjectmale
dc.subjectmiddle aged
dc.subjectminimum inhibitory concentration
dc.subjectnephrotoxicity
dc.subjectpriority journal
dc.subjectrate constant
dc.subjectsepsis
dc.subjectstatistical analysis
dc.subjectvolume of distribution
dc.subjectblood
dc.subjectcritical illness
dc.subjectdrug effects
dc.subjectintensive care
dc.subjectmicrobiology
dc.subjectprocedures
dc.subjectStaphylococcus aureus
dc.subjectStaphylococcus infection
dc.subjectAnti-Bacterial Agents
dc.subjectCohort Studies
dc.subjectCritical Care
dc.subjectCritical Illness
dc.subjectHumans
dc.subjectSepsis
dc.subjectStaphylococcal Infections
dc.subjectStaphylococcus aureus
dc.subjectVancomycin
dc.titlePharmacokinetic assessment of vancomycin loading dose in critically ill patients
dc.typeArticle


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