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KMID : 0869620130300030202
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Journal of Korean Society of Hospital Pharmacists
2013 Volume.30 No. 3 p.202 ~ p.209
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Comparative Antimicrobial Effect of Vancomycin Serum Trough Level and AUC24/MIC in Patients with MRSA Pneumonia
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Sohn Gee-Ho
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Abstract
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American Journal of Health-System Pharmacy (AJHP) recommended targeting vancomycin
trough concentrations of 10 mg/L or more because of therapeutic failure and potential risk of developing vancomycin resistance. Therefore, new dosage guidelines that could achieve
these higher targets were needed. However, these higher trough levels have potential risk, such as renal toxicity. The purpose of this study is to compare the antimicrobial effect of the trough vancomycin level and vancomycin area under the concentration-time curve from 0 to 24 h (AUC24)/minimum inhibitory concentration(MIC).
A retrospective, observational study set within pharmacist-managed clinical pharmacokinetic
service in a teaching hospital was performed. Patients with MRSA pneumonia and vancomycin
therapy between November 2009 and July 2010 were included (n=45). No difference between the MRSA positive group (n=17) and the MRSA negative group (n=28) were showed in the demo-graphic data and vancomycin trough level (p=0.925). However significant difference between the MRSA positive group (n=17) and MRSA negative group (n=28) were showed in AUC24/MIC 666.97 (95% CI, 419.18-1,295.51) and 1272.21 (95% CI, 1,011.6-1,389.46) respectively. (p=0.025)
In conclusion, targeted exposure using AUC24/MIC compared trough concentrations is a more
realistic target in patients with MRSA pneumonia.
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KEYWORD
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Vancomycin, MRSA pneumonia, Area under the concentration-time curve from 0 to 24 h/MIC ratio (AUC24/MIC)
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