Document Detail


Vancomycin pharmacokinetics in patients with severe burn injuries.
MedLine Citation:
PMID:  19875238     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Michael Dolton; Hongmei Xu; Elaine Cheong; Peter Maitz; Peter Kennedy; Thomas Gottlieb; Evette Buono; Andrew J McLachlan
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Publication Detail:
Type:  Journal Article     Date:  2009-10-28
Journal Detail:
Title:  Burns : journal of the International Society for Burn Injuries     Volume:  36     ISSN:  1879-1409     ISO Abbreviation:  Burns     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-04-13     Completed Date:  2010-12-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8913178     Medline TA:  Burns     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  469-76     Citation Subset:  IM    
Copyright Information:
(c) 2009 Elsevier Ltd and ISBI. All rights reserved.
Affiliation:
Faculty of Pharmacy, University of Sydney, Sydney, NSW, 2006, Australia.
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MeSH Terms
Descriptor/Qualifier:
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:
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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