Practice guidelines for therapeutic drug monitoring of vancomycin: a consensus review of the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring

Matsumoto, Kazuaki; Takesue, Yoshio; Ohmagari, Norio; Mochizuki, Takahiro; Mikamo, Hiroshige; Seki, Masafumi; Takakura, Shunji; Tokimatsu, Issei; Takahashi, Yoshiko; Kasahara, Kei; Okada, Kenji; Igarashi, Masahiro; Kobayashi, Masahiro; Hamada, Yukihiro; Kimura, Masao; Nishi, Yoshifumi; Tanigawara, Yusuke; Kimura, Toshimi

doi:10.1007/s10156-013-0599-4

Cited by 160 publications

(191 citation statements)

References 103 publications

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“…The use of an LD in critically ill patients is a widely recommended strategy and has been supported by several guides and studies (8)(9)(10)(11)(20)(21)(22)(23). Although there is no strong evidence to support the real clinical impact of this method, it has been suggested that its use is associated with better clinical cure rates in critically ill patients (24).…”

Section: Discussionmentioning

confidence: 99%

“…AUC 0 -24 /MIC values of Ն400 have demonstrated clinical and microbiological efficacy against lower respiratory tract infections by methicillinresistant Staphylococcus aureus (7), which have been later validated by international recommendations and guidelines (8)(9)(10)(11). On the other hand, lower values have shown not only poor infection eradication but also require longer treatments and a higher mortality rate (12)(13)(14).…”

mentioning

confidence: 95%

“…On the other hand, lower values have shown not only poor infection eradication but also require longer treatments and a higher mortality rate (12)(13)(14). In order to reach an appropriate PK/PD value, it has been proposed that trough levels between 15 and 20 g/ml for complicated infections are required (8,9,15). Serum levels of Ͻ10 and Ͼ20 g/ml have been linked to antibiotic resistance and nephrotoxicity, respectively (8,16).…”

mentioning

confidence: 99%

“…Three studies have suggested a standard prescribing dose of 25 to 30 mg/kg based mainly on body weight (8)(9)(10). However, considering only body weight for dosing might be inadequate in critically ill patients due to the characteristics and pharmacokinetic changes mentioned earlier.…”

mentioning

confidence: 99%

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Pharmacokinetic Assessment of Vancomycin Loading Dose in Critically Ill Patients

Álvarez

Plaza‐Plaza

Ramírez

et al. 2017

Antimicrob Agents Chemother

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The 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 AUC 0 -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 AUC 0 -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 AUC 0 -24 /MIC in critical patients.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 95%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Pharmacokinetic Assessment of Vancomycin Loading Dose in Critically Ill Patients

Álvarez

Plaza‐Plaza

Ramírez

et al. 2017

Antimicrob Agents Chemother

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“…10) No patients in this survey were diagnosed with severe infection and the optimal concentrations were defined as: VCM and TEIC, trough concentration of 10-20 µg/mL; ABK, trough concentration of <2.0 µg/ mL and peak concentration of 9-20 µg/mL. [11][12][13] Achievement was recorded if the optimal drug concentration was reached once during treatment. We checked the incidence of acute renal injury, defined as an increase in serum creatinine to ≥1.5 times baseline after drug administration.…”

Section: )mentioning

confidence: 99%

Clinical Evaluation of Pharmacist Interventions in Patients Treated with Anti-methicillin-Resistant <i>Staphylococcus aureus</i> Agents in a Hematological Ward

Okada

Fushitani

Azuma

et al. 2016

Biological & Pharmaceutical Bulletin

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The therapeutic effects of anti-methicillin-resistant Staphylococcus aureus (MRSA) agents, vancomycin (VCM), teicoplanin (TEIC), and arbekacin (ABK), depend on their concentrations in blood. Therefore, therapeutic drug monitoring (TDM) is important when these antibiotics are used. In the hematological ward at Tokushima University Hospital, pharmacists have ordered the measurement of blood VCM, TEIC, and ABK concentrations to promote the use of TDM in accordance with an agreed protocol since 2013. Moreover, the infection control team includes several medical disciplines and has advised on the optimal treatment using VCM, TEIC, and ABK since 2013. This study aimed to investigate the clinical effectiveness of these pharmacist interventions. We retrospectively studied 145 cases in which patients were treated with VCM, TEIC, or ABK between January 2012 and December 2013 in the hematological ward at Tokushima University Hospital. The patients were divided into a control group (71 cases) and an intervention group (74 cases), and their clinical outcomes were compared. The rate of achievement of effective drug concentrations significantly increased in the intervention group (74%), compared to the rate in the control group (55%). Moreover, univariate and multivariate Cox proportional hazard regression revealed that pharmacist intervention and appropriate concentrations of anti-MRSA agents were independent factors associated with reduced hospitalization periods in patients with lymphoma. Our study revealed that proactive pharmacist intervention may improve the therapeutic effect of anti-MRSA agents in hematology ward patients.

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PK / PD and the Drug Delivery Regimen for Infusion in the Critical Care Setting

Sime

Roberts

2021

Drug Delivery Approaches

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Practice guidelines for therapeutic drug monitoring of vancomycin: a consensus review of the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring

Cited by 160 publications

References 103 publications

Pharmacokinetic Assessment of Vancomycin Loading Dose in Critically Ill Patients

Pharmacokinetic Assessment of Vancomycin Loading Dose in Critically Ill Patients

Clinical Evaluation of Pharmacist Interventions in Patients Treated with Anti-methicillin-Resistant <i>Staphylococcus aureus</i> Agents in a Hematological Ward

PK / PD and the Drug Delivery Regimen for Infusion in the Critical Care Setting

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