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KMID : 0869620140310040888
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Journal of Korean Society of Hospital Pharmacists
2014 Volume.31 No. 4 p.888 ~ p.897
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Analysis of Vancomycin Plasma Concentrations Following Initial Dosing in Critically Ill Patients
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Lim Yu-Jin
Park Ka-Young
Jeon Su-Jeong
Namgung Hyung-Wook
Lee Eun-Sook
Song Kyoung-Ho
Park Sang-Heon
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Abstract
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Our study aims to analyze the effect of the initial dose of vancomycin in 146 critically ill patients, including those with impaired kidney function, in order to determine a clinically relevant loading dose (25~30 mg/kg). From January 1, 2010 ~ May 31, 2013, vancomycin dosage schedules and plasma concentrations in ICU patients in our hospital were collected. The plasma concentration was predicted prior to the next dose after the initial dose of vancomycin. The concentration at which vancomycin treatment failed was defined to be under 10 mg/l. The average concentration after the initial dose of vancomycin was 7.5±3.2 mg/l, which meant that only 20.5% of them reached the target concentration. Compared to the other groups, the one that received over 25 mg per kg, the initial concentration was 10.4±3.1 mg/l, which translated into 62.5% of them reaching the target concentration without differences in kidney function and a lower mortality rate 28 days after the vancomycin dose. In conclusion, a dose greater than 25 mg vancomycin per kg of body weight is required, regardless of kidney function, in order to reach therapeutic concentrations with only one dose prior to reaching the steady state.
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KEYWORD
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Vancomycin, Critically ill patients, Therapeutic drug monitoring
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