| Registro completo |
| Provedor de dados: |
BJID
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| País: |
Brazil
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| Título: |
Vancomycin serum concentrations in pediatric oncologic/hematologic intensive care patients
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| Autores: |
Silva,Dáfne Cardoso Bourguignon da
Seixas,Gláucia Toribio Finoti
Araujo,Orlei Ribeiro de
Arduini,Rodrigo Genaro
Carlesse,Fabianne Altruda de Moraes Costa
Petrilli,Antonio Sergio
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| Data: |
2012-08-01
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| Ano: |
2012
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| Palavras-chave: |
Immunosuppression
Drug resistance
Microbial
Staphylococcus
Anti-bacterial agents
Pharmacokinetics
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| Resumo: |
BACKGROUND: Usual treatment regimens with vancomycin often fail to provide adequate serum levels in patients with severe infections. METHODS: Retrospective analysis of vancomycin trough serum measurements. The following parameters were calculated by Bayesian analysis: vancomycin clearance, distribution volume, and peak estimated concentrations. The area under the concentration curve (AUC) (total daily dose/24 h clearance of vancomycin) was used to determine the effectiveness of treatment through the ratio of AUC/minimum inhibitory concentration (MIC) above 400, using MIC = 1 µg/mL, based on isolates of Staphylococci in cultures. RESULTS: Sixty-one vancomycin trough measurements were analyzed in 31 patients. AUC/MIC > 400 was obtained in 34 out of 61 dosages (55.7%), but the mean vancomycin dose required to achieve these levels was 81 mg/kg/day. In cases where the usual doses were administered (40-60 mg/kg/day), AUC/MIC > 400 was obtained in nine out of 18 dosages (50%), in 13 patients. Trough serum concentrations above 15 mg/L presented a positive predictive value of 100% and a negative predictive value of 71% for AUC/MIC > 400. CONCLUSION: Higher than usual vancomycin doses may be required to treat staphylococcal infections in children with oncologic/hematologic diseases. Since the best known predictor of efficacy is the AUC/MIC ratio, serum trough concentrations must be analyzed in conjunction with MICs of prevalent Staphylococci and pharmacokinetic tools such as Bayesian analysis.
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| Tipo: |
Info:eu-repo/semantics/article
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| Idioma: |
Inglês
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| Identificador: |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702012000400009
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| Editor: |
Brazilian Society of Infectious Diseases
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| Relação: |
10.1016/j.bjid.2012.06.011
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| Formato: |
text/html
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| Fonte: |
Brazilian Journal of Infectious Diseases v.16 n.4 2012
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| Direitos: |
info:eu-repo/semantics/openAccess
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