Comparative Examination of the Initial Dosage Setting of Vancomycin Therapy in the Adult MRSA Patients.

Teramachi, Hitomi; Hatakeyama, Hiromi; Matsushita, Ryo; Imai, Yukio; Miyamoto, Katsuhiko; Tsuji, Akira

doi:10.5649/jjphcs.28.530

Cited by 8 publications

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“…They reported that Maeda's method achieved the therapeutic range more frequently than the other 3 methods, and that the Bayesian focusing technique was valuable in correcting the vancomycin dosage regimen more precisely. 22) Collectively, our previous report, 12) the present report, and the reports by Teramachi et al 21) and Nagano et al 23) demonstrate the clinical usefulness of Maeda's method in setting the initial dosage regimen in vancomycin therapy for adult MRSA patients.…”

Section: Discussionsupporting

confidence: 73%

“…Our data may support the suggestion that achieving higher AUIC of plasma vancomycin in the early stage of vancomycin therapy leads to higher clinical e‹cacy, as reported previously. [19][20][21] Recently, Teramachi et al 22) evaluated retrospectively the clinical e‹cacies of Moellering's method, Marzke's method, Maeda's method , and the population mean method, using vancomycin TDM data obtained in 72 adult MRSA patients. They reported that Maeda's method achieved the therapeutic range more frequently than the other 3 methods, and that the Bayesian focusing technique was valuable in correcting the vancomycin dosage regimen more precisely.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of Clinical Efficacy of Maeda’s Nomogram for Vancomycin Dosage Adjustment in Adult Japanese MRSA Pneumonia Patients

Maeda

Omoda

Fukuhara

et al. 2006

Drug Metabolism and Pharmacokinetics

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The clinical efficacy of Maeda's nomogram for vancomycin dosage adjustment was evaluated by comparison with a standard dosage regimen (package insert information: vancomycin dose reduced in elderly patients and patients with renal dysfunction, with Moellering's nomogram used for renal-dysfunction patients) in adult Japanese MRSA pneumonia patients. Using Maeda's nomogram, the vancomycin dose is fixed at 1,000 mg while the dosing interval is varied in accordance with individual creatinine clearance. Using a standard dosage regimen, 5 patients out of 27 (18.5%) achieved target plasma levels of vancomycin (25-40 microg/mL for peak and 5-15 microg/mL for trough) within 2-6 days. Using Maeda's nomogram, 38 patients out of 53 (71.7%) achieved target levels in that time. A higher clinical response (complete resolution of all signs and symptoms of MRSA infection) to vancomycin therapy was also obtained with Maeda's nomogram when evaluated approximately 2-weeks after discontinuation of vancomycin therapy (43.4% versus 18.5% for the standard regimen). In conclusion, the Maeda's nomogram regimen with a 1,000 mg vancomycin dose was shown to achieve target plasma levels of vancomycin at a higher rate and provide higher clinical efficacy in vancomycin therapy of MRSA pneumonia patients, as compared with the currently available standard dosage regimen.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Evaluation of Clinical Efficacy of Maeda’s Nomogram for Vancomycin Dosage Adjustment in Adult Japanese MRSA Pneumonia Patients

Maeda

Omoda

Fukuhara

et al. 2006

Drug Metabolism and Pharmacokinetics

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Analysis of Factor on Selecting Anti-<i>Methicillin-resistant Staphylococcus aureus</i> Drugs by Doctor

et al. 2008

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Three types of medication, Arbekacin, Vancomycin, and Teicoplanin, are used primarily to treat MRSA infections. These medications diŠer in their respective anti-bacterial actions, antibacterial spectrums, and pharmacokinetics. Proper use and dosage is required, and is based on patient background and the conditions of infection, among other factors. This study was conducted for a period of over one year at St. Marianna University School of Medicine, Yokohama City Seibu Hospital. It was designed to compare the conditions as they related to why doctors ordered a certain drug, the background, and their clinical examination values. The tendency to avoid selection of Arbekacin Sulfate (ABK) for patients who had kidney dysfunction was recognized, although there were a few exceptions made. Other than that, there were not any standard criteria set in selecting which medication to prescribe. Therefore, it is necessary to examine the appropriateness of the selection since ordering anti-MRSA medication seemed to depend on each doctor's own experience. Serum concentration was measured in order to avoid any side eŠects. Moreover, cases of young people, normal renal function and malignant tumor patients were recognized in which serum concentration of the anti-MRSA medications was not within the therapeutic range of therapeutic drug monitoring (TDM). This was to show that there is a possibility the medications involved were not su‹ciently eŠective. Therefore, in the future it will be necessary to ensure that proper dosing instructions are followed.

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Forty-three Years of Dedicated Efforts in Advancing Pharmacist Expertise: Aspiring to Become a Pharmacist and Cultivate Pharmacists Proficient in Recommending Prescription Medicines to Doctors

Teramachi

2024

YAKUGAKU ZASSHI

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When I graduated from university, my aim was to become a pharmacist capable of recommending prescription medicines to doctors and teaching others to do the same. To achieve this goal, I developed comprehensive curricula incorporating progressive educational tools such as problem-based learning and small group discussions. Subsequently, the effectiveness of these tools and curricula was evaluated, and the findings of these assessments were published in various peer-reviewed journal articles. Consequently, a body of evidence on the most effective ways to recommend prescription medicines to doctors was gradually established. This paper aims to summarize this comprehensive body of research spanning over 43 years, with the objective of highlighting the valuable insights gained thus far, identifying the best practice techniques, and exploring potential avenues for future research.

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Comparative Examination of the Initial Dosage Setting of Vancomycin Therapy in the Adult MRSA Patients.

Cited by 8 publications

References 0 publications

Evaluation of Clinical Efficacy of Maeda’s Nomogram for Vancomycin Dosage Adjustment in Adult Japanese MRSA Pneumonia Patients

Evaluation of Clinical Efficacy of Maeda’s Nomogram for Vancomycin Dosage Adjustment in Adult Japanese MRSA Pneumonia Patients

Analysis of Factor on Selecting Anti-<i>Methicillin-resistant Staphylococcus aureus</i> Drugs by Doctor

Forty-three Years of Dedicated Efforts in Advancing Pharmacist Expertise: Aspiring to Become a Pharmacist and Cultivate Pharmacists Proficient in Recommending Prescription Medicines to Doctors

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