|
KMID : 0853020080110020096
|
|
Journal of Korean Burn Society
2008 Volume.11 No. 2 p.96 ~ p.98
|
|
|
Vancomycin Therapeutic Drug Monitoring in Massive Burn Patients
|
|
Yim Hae-Jun
Lee Boung-Chul
Seo Cheon-Hoon
Kim Do-Hern
Hur Jun
Chun Wook
Cho Yong-Suk
Kim Jong-Hyun
Chee Soo-Hyun
Hwang Bo-Young
Kim Ji-Youn
|
|
|
Abstract
|
|
|
Purpose: Patients with extensive burn injuries are especially susceptible to infection with methicillin-resistant Staphylococcus aureus (MRSA) due to loss of the skin barrier and reduced immunological capacity. MRSA infection in patients with burns is an extremely important in their treatment. The infections are often severe and life-threatening. Vancomycin or Teicopanin are drug of choice of MRSA infection. Optimizing antimicrobial therapy in these patients can be challenging due to physiologic alteration affecting organ functions and drug metabolism. This study has been conducted to discover alteration of vancomycin drug level in severe burn patients.
Methods: We analyzed vancomycin data from 43 patients admitted to our burn center between Apr 2007 and Nov 2008. We divided into two groups according to serum vancomycin levels.
Results: All patients were managed in burn intensive care unit. Twelve patients (8 males and 4 females, mean age 46.9 years) were clinically classified with therapeutic range group (TR). Thirty one patients (27 males and 4 females, mean age 42.4 years) were clinically classified with subtherapeutic range group (STR). In TR group, vancomycin trough level is 12.90 (mcg/mL). Cretinine clearance (CCr) and T1/2 (hr) are 106.38 (ml/min), 4.56 hours, respectively. In STR group, vancomycin trough level is 3.40 (mcg/mL). Cretinine clearance (CCr) and T1/2 (hr) are 106.38 (ml/min), 4.56 hours, respectively.
Conclusion: The circulating levels of vancomycin proved to be inadequate in spite of the dosage shceme used (500 mg, four times a day) in 31 patients. Burn patients often require increased doses of vancomycin, which is casued most probably to increased renal excretion. Therefore, All patients using vancomycin should be monitoring and individualization.
|
|
|
KEYWORD
|
|
|
MRSA, Vancomycin, Burns
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|