Vancomycin Pharmacokinetics in Normal and Morbidly Obese Subjects

Blouin, Robert A.; Bauer, Larry A.; Miller, Delwyn D.; Record, Kenneth E.; Griffen, Ward O.

doi:10.1128/aac.22.1.180-a

Cited by 43 publications

(81 citation statements)

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“…3 This is substantiated physiologically by the fact that vancomycin distributes into lipophilic tissues and demonstrates increased volume in obese patients. [3][4][5] Though studies have shown that V Vanco is related to ABW, a wide range of values for V Vanco have been reported. 6 Average values, such as 0.7-0.9 L/kg have been used, but reports include values ranging from 0.26 to 1.25 L/kg.…”

Section: Peak-trough Vancomycin Dosingmentioning

confidence: 99%

AUC Versus Peak–Trough Dosing of Vancomycin

Brown

Lalla

Masselink

2013

Therapeutic Drug Monitoring

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An understanding of pharmacokinetic and pharmacodynamic principles, including the relevance of AUC in relation to MIC, enables clinicians to make the best use of vancomycin dosing options. The proposed dosing chart is pharmacokinetically valid but has yet to be applied clinically. It provides a foundation for further study of how clinicians can determine an optimal AUC-based starting vancomycin dosing regimen without having to derive ClVanco or AUC24.

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Section: Peak-trough Vancomycin Dosingmentioning

confidence: 99%

AUC Versus Peak–Trough Dosing of Vancomycin

Brown

Lalla

Masselink

2013

Therapeutic Drug Monitoring

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“…Other studies have focused on patient populations that may require altered vancomycin dosing due to changes in vancomycin’s volume of distribution (Vd) or clearance (Cl) (Table 2) [42-48]. Some of these studies obtained pharmacokinetic data after only one dose of vancomycin [34,39,43]. While this information is valuable in knowing if vancomycin concentrations are adequate after the first dose is administered, it fails to provide any information regarding vancomycin pharmacokinetics at steady state.…”

Section: What Patient Populations May Require Altered Dosing To Achiementioning

confidence: 99%

“…Blouin et al described vancomycin pharmacokinetics in four normal weight patients and six morbidly obese patients (111.4–226.4 kg) that were 37 years of age or younger [43]. The morbidly obese patients were status-post-gastric bypass surgery.…”

Section: What Patient Populations May Require Altered Dosing To Achiementioning

confidence: 99%

Use of vancomycin pharmacokinetic–pharmacodynamic properties in the treatment of MRSA infections

Giuliano¹,

Haase²,

Hall³

2010

Expert Review of Anti-infective Therapy

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Vancomycin is a commonly used antimicrobial in patients with methicillin-resistant Staphylococcus aureus (MRSA) infections. Increasing vancomycin MIC values in MRSA clinical isolates makes the optimization of vancomycin dosing pivotal to its continued use. Unfortunately, limited data exist regarding the optimal pharmacokinetic–pharmacodynamic (PK–PD) goal to improve bacterial killing and clinical outcomes with vancomycin. The hallmark study in this area suggests that achieving an AUC to MIC ratio of over 400 improves the likelihood of achieving these outcomes. Challenges in the implementation of PK–PD-based dosing for vancomycin include current methodologies utilized in microbiology laboratories, as well as intra- and interpatient pharmacokinetic variability. Individualized dosing based on MIC and specific patient factors is important to achieve optimal outcomes from vancomycin therapy.

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“…For the aminoglycosides, both the Vd and Cl are increased in obesity, and appear to offset one another [68–73]. Since the aminoglycosides exhibit a concentration-dependent mechanism of action, achieving appropriate peak concentrations is most important.…”

Section: Antimicrobial Prophylaxis: Overviewmentioning

confidence: 99%

“…There have been several reports regarding vancomycin pharmacokinetics in obesity, although they are not specific to bariatric surgery [73,79–82]. Vancomycin Cl appears to increase uniformly with obesity across studies [61].…”

Section: Antimicrobial Prophylaxis: Overviewmentioning

confidence: 99%

Preventing surgical site infections after bariatric surgery: value of perioperative antibiotic regimens

Chopra

Zhao

Alangaden

et al. 2010

Expert Review of Pharmacoeconomics & Outcomes Research

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Bariatric surgery for obesity has emerged as an effective and commonly used treatment modality. This paper reviews the surgical site infections (SSIs) that occur post bariatric surgery and SSI prevention. The benefit of bariatric surgery resulting in profound weight loss brings with it consequences in the form of postoperative complications that can have profound effects on morbidity and mortality in these patients. This paper sets out to define different types of SSIs that occur following bariatric surgery and to discuss existing literature on the critical aspects of SSI prevention and the appropriate use of surgical antimicrobial prophylaxis for bariatric surgery.

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Vancomycin Pharmacokinetics in Normal and Morbidly Obese Subjects

Cited by 43 publications

References 0 publications

AUC Versus Peak–Trough Dosing of Vancomycin

AUC Versus Peak–Trough Dosing of Vancomycin

Use of vancomycin pharmacokinetic–pharmacodynamic properties in the treatment of MRSA infections

Preventing surgical site infections after bariatric surgery: value of perioperative antibiotic regimens

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