Vancomycin: The Tale of the Vanquisher and the Pyrrhic Victory

Vriese, An S. De; Vandecasteele, Stefaan

doi:10.3747/pdi.2014.00001

Cited by 11 publications

(13 citation statements)

References 53 publications

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“…Clinically, the target concentration intervention (TCI) has been widely applied and can help maximize clinical benefits [23,24] . For TCI, a proper Pop-PK model is required [25,26] and is valuable in highly variable populations that are receiving a drug with a narrow therapeutic window, eg, vancomycin [27] . TCI focuses on the estimation of the initial dose to achieve the target concentration by calculating the pharmacokinetic (PK) and pharmacodynamic (PD) parameters according to the relevant covariates, such as dosage, treatment duration, and clinical effects during treatment [28] .…”

Section: Introductionmentioning

confidence: 99%

Influences of renal function descriptors on population pharmacokinetic modeling of vancomycin in Chinese adult patients

et al. 2017

Acta Pharmacol Sin

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Vancomycin, a glycopeptide antibiotic for the treatment of grampositive infections, is mainly eliminated via glomerular filtration. Thus, its therapeutic effects are affected predominantly by renal function. The aim of this study was to develop a population pharmacokinetic model of vancomycin for Chinese adult patients and to investigate the influence of different renal function descriptors on the predictability of the model. A retrospective analysis was performed based on the blood concentrations of vancomycin in 218 Chinese adult patients. Among these patients, the data from 160 were used to establish the population pharmacokinetic model, and the data from the remaining 58 patients were used for external model validation. A simulation was employed to determine the appropriate initial vancomycin dosage regimens in adult Chinese patients for reaching the target steady-state trough concentrations of 10-15 mg/L and 15-20 mg/L. We developed a one-compartment model with first-order absorption to characterize the concentration-time profile of vancomycin. There was a positive correlation between the body clearance of vancomycin and renal function; both creatinine clearance (CL) and age were the covariates that influenced the PK of vancomycin, and the excretion of vancomycin decreased as renal function diminishing with age. The typical clearance (CL) value was 2.829 L/h for 75-year-old patients with CL values of 80 mL/min, and the rate constant of CL with the CL changing at 1 mL/min was 0.00842. The influence coefficient of age on CL was 0.08143. The external validation results revealed that the current different descriptors of renal function behaved similarly to the predicted performance of the models. In conclusion, the developed model is appropriate for Bayesian dose predictions of vancomycin concentrations in the population of Chinese adult patients. Furthermore, the simulation provides a reference for clinical optimized antibacterial therapy with vancomycin.

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Section: Introductionmentioning

confidence: 99%

Influences of renal function descriptors on population pharmacokinetic modeling of vancomycin in Chinese adult patients

et al. 2017

Acta Pharmacol Sin

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“…MRSA is reported to have distinctive phenotypic and genetic features whether community or hospital acquired (Mammina et al, 2012). Evidence have shown that some strains of S. aureus are found to be resistant to the last line antibiotics (Park and Lui, 2012;De Vriese and Vandecasteele, 2014) and this has restricted the options available for its treatment in many regions of the world (Subedi and Brahmadathan, 2005). One of such regions is Nigeria (Akinyemi et al, 1997) where antibiotic resistance may be due to spontaneous mutation or acquired through plasmid transfer from other resistant bacteria (Bhaktar et al, 2003).…”

mentioning

confidence: 99%

Plasmid profile of multi antibiotic resistant staphylococcus aureus isolated from diabetic wounds from patients at Nsukka, South-eastern, Nigeria

Badger-Emeka¹,

Emeka²,

Dibua³

2014

Afr. J. Biotechnol.

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“…There are no reports of this phenomenon with IP vancomycin in adult patients, presumably related to the slow rate of absorption of vancomycin through the peritoneal membrane. In adult PD patients, the bioavailability of IP vancomycin following a 4- to 6-hour exchange is between 30 and 70%, a major factor limiting a rapid rise in plasma levels [9]. …”

Section: Discussionmentioning

confidence: 99%

“…Despite this theoretical concern, relapse rates do not appear to be higher among patients treated with automated PD compared with continuous ambulatory PD [15]. An alternative IP vancomycin dosing strategy has been proposed that involves 25 mg/L of vancomycin in each exchange rather than large doses given every few days [9]. This has the advantage of achieving higher intraperitoneal concentrations and preventing potentially risky systemic levels, though it is certainly more onerous.…”

Section: Discussionmentioning

confidence: 99%

Systemic Toxicity of Intraperitoneal Vancomycin

Kumar

Teo

McCormick

2016

Case Reports in Nephrology

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Intraperitoneal vancomycin is used for empiric treatment of peritoneal dialysis peritonitis. It is dosed intermittently and a high systemic concentration is often achieved. Despite this, there are very few reports of systemic toxicity from intraperitoneal vancomycin. We report the course of a patient who developed a drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome after three weeks of intraperitoneal vancomycin. We review the literature and conclude that this is the first ever reported case of DRESS syndrome from intraperitoneal vancomycin.

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Vancomycin: The Tale of the Vanquisher and the Pyrrhic Victory

Cited by 11 publications

References 53 publications

Influences of renal function descriptors on population pharmacokinetic modeling of vancomycin in Chinese adult patients

Influences of renal function descriptors on population pharmacokinetic modeling of vancomycin in Chinese adult patients

Plasmid profile of multi antibiotic resistant staphylococcus aureus isolated from diabetic wounds from patients at Nsukka, South-eastern, Nigeria

Systemic Toxicity of Intraperitoneal Vancomycin

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