| Vancomycin pharmacokinetics in patients with severe burn injuries. | |
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MedLine Citation:
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PMID: 19875238 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Vancomycin is used in patients with severe burns and methicillin-resistant Staphylococcus aureus (MRSA) infection. This study investigated vancomycin pharmacokinetics in people with burns in comparison to people without burns and examined the factors contributing to pharmacokinetic variability. This was a retrospective, case-control study of hospitalised burns patients compared with a control patient cohort administered vancomycin without burn injury. Vancomycin pharmacokinetic parameters were determined using therapeutic drug monitoring data and a population pharmacokinetic modelling approach employing a two-compartment pharmacokinetic model. The impact of patient characteristics on vancomycin clearance was explored. Vancomycin clearance was significantly higher (p<0.001) in burns patients (5.9+/-3.1L/h, n=37) when compared to control patients (3.4+/-1.8 L/h, n=33), as was estimated creatinine clearance, which was correlated to drug clearance in burns patients (r(2)=0.64). There was no significant change in volume of distribution between patient groups. The majority of patients received a dosing regimen of 1g twice daily, resulting in significantly (p=0.004) lower serum trough concentrations in patients with burns (median, 6.4 mg/L; range, 0.2-22.3mg/L) than control (median, 9.2mg/L; range, 4.0-29.8 mg/L). Higher clearance and lower serum vancomycin concentrations in people with severe burn may increase the risk of suboptimal bactericidal action and the development of resistance highlighting the need for dosage individualization. |
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Authors:
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Michael Dolton; Hongmei Xu; Elaine Cheong; Peter Maitz; Peter Kennedy; Thomas Gottlieb; Evette Buono; Andrew J McLachlan |
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Publication Detail:
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Type: Journal Article Date: 2009-10-28 |
Journal Detail:
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Title: Burns : journal of the International Society for Burn Injuries Volume: 36 ISSN: 1879-1409 ISO Abbreviation: Burns Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-04-13 Completed Date: 2010-12-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8913178 Medline TA: Burns Country: Netherlands |
Other Details:
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Languages: eng Pagination: 469-76 Citation Subset: IM |
Copyright Information:
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(c) 2009 Elsevier Ltd and ISBI. All rights reserved. |
Affiliation:
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Faculty of Pharmacy, University of Sydney, Sydney, NSW, 2006, Australia. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Anti-Bacterial Agents / administration & dosage, pharmacokinetics* Burns / drug therapy, metabolism* Case-Control Studies Dose-Response Relationship, Drug Female Humans Male Metabolic Clearance Rate Middle Aged Retrospective Studies Vancomycin / administration & dosage, pharmacokinetics* Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents; 1404-90-6/Vancomycin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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