A simulation of loading doses for vancomycin continuous infusion regimens in intensive care

Šíma, Martin; Hronová, Karolína; Hartinger, Jan Miroslav; Slanař, Ondřej

doi:10.1080/23744235.2017.1328741

Cited by 6 publications

(2 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thus, vancomycin for systemic infections should ideally be administered repeatedly or via continuous infusion with a loading dose sufficient for rapid and effective exposure [28,29].…”

Section: Discussionmentioning

confidence: 99%

Vancomycin-releasing cross-linked collagen sponges as wound dressings

Hartinger

Mitáš

Mlček

et al. 2019

Bosn J of Basic Med Sci

Self Cite

View full text Add to dashboard Cite

The study presents a novel vancomycin-releasing collagen wound dressing derived from Cyprinus carpio collagen type I cross-linked with carbodiimide which retarded the degradation rate and increased the stability of the sponge. Following lyophilization, the dressings were subjected to gamma sterilization. The structure was evaluated via scanning electron microscopy images, micro-computed tomography, and infrared spectrometry. The structural stability and vancomycin release properties were evaluated in a phosphate buffer solution. Microbiological testing and a rat model of a wound infected with methicillin-resistant Staphylococcus aureus (MRSA) were then employed to test the efficacy of the treatment of the infected wound. Following an initial mass loss due to the release of vancomycin, the sponges remained stable. After 7 days of exposure in phosphate buffered saline (37°C), 60% of the material remained with a preserved collagen secondary structure together with a high degree of open porosity (over 80%). The analysis of the release of the vancomycin revealed the homogeneous distribution of the antibiotic both across and between the sponges. The release of vancomycin was retarded as proved by in vitro testing and further confirmed by the animal model from which measurable concentrations were observed in blood samples 24 hours after the subcutaneous implantation of the sponge, which was more than observed following i. p. administration. The sponge was also highly effective in terms of reducing the number of colony-forming units in biopsies extracted from the infected wounds 4 days following the inoculation of the wounds with the MRSA solution.

show abstract

“…Thus, vancomycin for systemic infections should ideally be administered repeatedly or via continuous infusion with a loading dose sufficient for rapid and effective exposure [28,29].…”

Section: Discussionmentioning

confidence: 99%

Vancomycin-releasing cross-linked collagen sponges as wound dressings

Hartinger

Mitáš

Mlček

et al. 2019

Bosn J of Basic Med Sci

Self Cite

View full text Add to dashboard Cite

show abstract

“…We focused only on maintenance dosing in this study; however, in order to achieve a rapid attainment of the target concentration for seriously ill patients, a loading dose administration can be considered 12 13…”

Section: Discussionmentioning

confidence: 99%

Initial dosing of intermittent vancomycin in adults: estimation of dosing interval in relation to dose and renal function

et al. 2019

Self Cite

View full text Add to dashboard Cite

ObjectivesDue to the high interindividual variability in vancomycin pharmacokinetics, optimisation of its dosing is still challenging. This study aimed to explore vancomycin pharmacokinetics in adult patients and to propose an easy applicable dosing nomogram for initial treatment.MethodsVancomycin pharmacokinetics was calculated in a two-compartmental model based on therapeutic drug monitoring data. A linear regression model was used to explore the relationship between vancomycin elimination half-life and glomerular filtration rate estimated according the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula.ResultsIn the whole study population (n=66), vancomycin volume of distribution, clearance and half-life median (IQR) values were 0.69 (0.58–0.87) L/kg, 0.031 (0.022–0.050) L/h/kg and 14.4 (9.5–25.2) hours, respectively. Vancomycin half-life was associated with glomerular filtration rate (r2=0.4126, p<0.0001) according to the formula: t1/2 (h) = −0.247×eGFRCKD-EPI (mL/min/1.73 m2)+32.89. This relationship was used to construct a dosing nomogram.ConclusionsWe propose an easy-to-use dosing nomogram for vancomycin therapy initiation that allows individualisation of the dosing interval with respect to the administered dose size and functional renal status.

show abstract