Association between single trough-based area under the curve estimation of vancomycin and treatment outcome among methicillin-resistant Staphylococcus aureus bacteremia patients.
Adult
Aged
Anti-Bacterial Agents
/ administration & dosage
Area Under Curve
Bacteremia
/ drug therapy
Critical Illness
Female
Humans
Male
Methicillin-Resistant Staphylococcus aureus
/ isolation & purification
Microbial Sensitivity Tests
Middle Aged
Retrospective Studies
Staphylococcal Infections
/ drug therapy
Treatment Outcome
Vancomycin
/ administration & dosage
AUC
MIC
MRSA
critical care
trough concentration
vancomycin
Journal
Anaesthesiology intensive therapy
ISSN: 1731-2531
Titre abrégé: Anaesthesiol Intensive Ther
Pays: Poland
ID NLM: 101472620
Informations de publication
Date de publication:
2019
2019
Historique:
pubmed:
23
8
2019
medline:
31
7
2020
entrez:
23
8
2019
Statut:
ppublish
Résumé
Failure of antibiotic treatment increases mortality of critically ill patients. This study investigated the association between the treatment resolution of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia and vancomycin pharmacokinetic variables. A total of 28 critically ill patients were included in this study. All data were collected from medical, microbiology and pharmacokinetic records. The clinical response was evaluated on the basis of clinical and microbiological parameters. The 24-h area under the curve (AUC<SUB>0-24</SUB>) was estimated from a single trough level using established equations. Out of the 28 patients, 46% were classified as responders to vancomycin treatment. The trough vancomycin concentration did not differ between the responders and non-responders (15.02 ± 6.16 and 14.83 ± 4.80 μg mL Ratio of trough concentration/MIC and AUC<SUB>0-24</SUB>/MIC of vancomycin are better predictors for MRSA treatment outcomes than trough vancomycin concentration or AUC<SUB>0-24</SUB> alone. The single trough-based estimated AUC may be sufficient for the monitoring of treatment response with vancomycin.
Sections du résumé
BACKGROUND
Failure of antibiotic treatment increases mortality of critically ill patients. This study investigated the association between the treatment resolution of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia and vancomycin pharmacokinetic variables.
METHODS
A total of 28 critically ill patients were included in this study. All data were collected from medical, microbiology and pharmacokinetic records. The clinical response was evaluated on the basis of clinical and microbiological parameters. The 24-h area under the curve (AUC<SUB>0-24</SUB>) was estimated from a single trough level using established equations.
RESULTS
Out of the 28 patients, 46% were classified as responders to vancomycin treatment. The trough vancomycin concentration did not differ between the responders and non-responders (15.02 ± 6.16 and 14.83 ± 4.80 μg mL
CONCLUSIONS
Ratio of trough concentration/MIC and AUC<SUB>0-24</SUB>/MIC of vancomycin are better predictors for MRSA treatment outcomes than trough vancomycin concentration or AUC<SUB>0-24</SUB> alone. The single trough-based estimated AUC may be sufficient for the monitoring of treatment response with vancomycin.
Identifiants
pubmed: 31434472
pii: 37453
doi: 10.5114/ait.2019.87362
pii:
doi:
Substances chimiques
Anti-Bacterial Agents
0
Vancomycin
6Q205EH1VU
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM