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KMID : 0984720090410040224
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Infection and Chemotherapy
2009 Volume.41 No. 4 p.224 ~ p.229
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Evaluation of the Effect of Initial dose of Vancomycin using Serum Cystatin C as a Marker in Elderly Patients
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Jin Sung-Joon
Choi Jun-Yong
Song Young-Goo
Kim June-Myung
Bae Sung-Chang
Kim Hye-Won
Kim Hye-Kyung
Na Eun-Joo
Ahn Bo-Sook
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Abstract
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Background: It has been suggested that the glomerular filtration rate can be predicted on the basis of serum cystatin C concentration. The aim of this study was to investigate the clinical utility of serum cystatin C as a marker of renal function and to evaluate the effect of an initial dose of vancomycin using serum cystatin C concentration in elderly patients.
Materials and Methods: Data was collected from July 2006 to September 2008. The subjects were elderly patients (≥60-years-of-age; n=number of patients) who had been treated with vancomycin. Serum concentrations of parameters including vancomycin, creatinine, and cystatin C were measured. Correlations between measured vancomycin concentrations and predicted vancomycin concentrations based on serum cystatin C or serum creatinine were compared, and the initial dose setting of vancomycin on the basis of serum cystatin C concentration was evaluated.
Results: Serum cystatin C was a good marker of renal function in comparison with serum creatinine for various doses of vancomycin in the elderly subject. In subpopulation (n=88) with normal serum cystatin C level (≤1.2 mg/L) who were treated with routine adult vancomycin dose (1g q 12 hours), vancomycin concentration was within the therapeutic range (5-15 mg/L) in 68 patients (77.3%), and was <20 mg/L in 77 of the 88 patients (88.5 %).
Conclusions: Predictive prowess of serum vancomycin concentrations on the basis of the serum cystatin C concentration could be better than that based on the serum creatinine concentration in elderly patients.
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KEYWORD
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Vancomycin, Therapeutic drug monitoring, Cystatin C
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