Prospectively Validated Dosing Nomograms for Maximizing the Pharmacodynamics of Vancomycin Administered by Continuous Infusion in Critically Ill Patients

Pea, Federico; Furlanut, Mario; Negri, Camilla; Pavan, Federica; Crapis, Massimo; Cristini, Francesco; Viale, Pierluigi

doi:10.1128/aac.01149-08

Cited by 111 publications

(81 citation statements)

References 39 publications

(45 reference statements)

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“…Combination MICs of vancomycin and its structurally related compounds declined below the susceptibility break point in half of the isolates. Synergy was observed (FICI: ≤ 0.5), and the concentrations of the drugs in combination decreased below the minimal steady-state concentrations achieved with standard dosing regimens of colistin 11 and continuously infused vancomycin 12 and norvancomycin 13 . The effi cacy of low doses of colistin was also supported by the results of the time-kill assays.…”

Section: Discussionmentioning

confidence: 99%

“…Colistin was added at 0.125μg/ml (1/4 MIC), vancomycin at 16μg/ml, and norvancomycin at 8μg/ ml to mimic the minimal steady-state concentrations achieved with standard dosing regimens of colistin methanesulfonate (1,000,000IU colistin) 11 and continuously infused vancomycin 12 and norvacomycin 13 . Linezolid was added at 8μg/ml, a concentration that mimics the minimal steady-state plasma concentration achieved with intravenous administration of 600mg/12h 14 .…”

Section: Time-kill Assaysmentioning

confidence: 99%

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Colistin and anti-Gram-positive bacterial agents against Acinetobacter baumannii

Liu

et al. 2014

Rev. Soc. Bras. Med. Trop.

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Introduction:Acinetobacter baumannii has attained an alarming level of resistance to antibacterial drugs. Clinicians are now considering the use of older agents or unorthodox combinations of licensed drugs against multidrug-resistant strains to bridge the current treatment gap. We investigated the in vitro activities of combination treatments that included colistin with vancomycin, norvancomycin or linezolid against multidrug-resistant Acinetobacter baumannii. Methods: The fractional inhibitory concentration index and time-kill assays were used to explore the combined effects of colistin with vancomycin, norvancomycin or linezolid against 40 clinical isolates of multidrug-resistant Acinetobacter baumannii. Transmission electron microscopy was performed to evaluate the interactions in response to the combination of colistin and vancomycin. Results: The minimum inhibitory concentrations (MICs) of vancomycin and norvancomycin for half of the isolates decreased below the susceptibility break point, and the MIC of linezolid for one isolate was decreased to the blood and epithelial lining fl uid concentration using the current dosing regimen. When vancomycin or norvancomycin was combined with subinhibitory doses of colistin, the multidrug-resistant Acinetobacter baumannii test samples were eradicated. Transmission electron microscopy revealed that subinhibitory doses of colistin were able to disrupt the outer membrane, facilitating a disruption of the cell wall and leading to cell lysis. Conclusions: Subinhibitory doses of colistin signifi cantly enhanced the antibacterial activity of vancomycin, norvancomycin, and linezolid against multidrug-resistant Acinetobacter baumannii.

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Section: Discussionmentioning

confidence: 99%

Section: Time-kill Assaysmentioning

confidence: 99%

Colistin and anti-Gram-positive bacterial agents against Acinetobacter baumannii

Liu

et al. 2014

Rev. Soc. Bras. Med. Trop.

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“…Given these pharmacodynamic characteristics, one would predict that the time that the vancomycin serum level exceeds the MIC would be the pharmacodynamic parameter that most strongly correlates with efficacy [5].…”

Section: Discussionmentioning

confidence: 99%

A higher dose of vancomycin in continuous infusion is needed in critically ill patients

Jeurissen¹,

Sluyts

Rutsaert³

2011

International Journal of Antimicrobial Agents

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International audienceCompared with intermittent infusion, continuous infusion of vancomycin is cheaper and logistically more convenient, achieves target concentrations faster, results in less variability in serum vancomycin concentrations, requires less therapeutic drug monitoring and causes less nephrotoxicity. Given that critically ill patients may develop very large volumes of distribution as well as supranormal drug clearance, in this study it was shown, despite the limited number of patients studied, that to achieve a target plateau concentration of 25mg/L a daily dose of 3000mg of vancomycin in continuous infusion is needed following an appropriate loading dose

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“…Em outros estudos realizados anteriormente que avaliaram os níveis séricos de vancomicina, também houve predominância de pacientes do sexo masculino, fato que facilita a comparação entre dados (PEA et al, 2009;DE WAELE et al, 2013). No entanto, Pea (2009) A dose mais frequentemente administrada de vancomicina foi de 1g (32,9 %) para os adultos e de 15 mg/kg (24,3%) para as crianças e neonatos.…”

Section: Resultsunclassified

Avaliação Dos Níveis Séricos De Vancomicina Em Pacientes Internados Em Um Hospital De Ensino Da Região Central Do Rio Grande Do Sul

Zanotto

Wappler

d’Azevedo

et al. 2014

RJP

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RESUMOA vancomicina é um antibiótico glicopeptídeo efetivo em infecções graves por bactérias gram-positivas. Necessita atingir um nível sérico adequado para alcançar efetividade terapêutica e requer monitorização constante durante seu uso uma vez que pode causar toxicidade. O objetivo deste trabalho foi verificar qual o nível sérico de vancomicina nos pacientes internados em um hospital de ensino da região central do Rio Grande do Sul. Este estudo foi realizado com 69 pacientes, sendo 22 recém-nascidos, no período de julho de 2012 a dezembro 2013. As dosagens séricas de vancomicina foram realizadas após 72 horas do início do tratamento com o antimicrobiano, 30 minutos antes de sua administração através de imunoensaio de micropartículas por quimioluminescência. Foram realizadas e analisadas 117 dosagens séricas de vancomicina, sendo que apenas 19,4% das dosagens permaneceram na faixa ideal (10-20 µg/mL), enquanto que 38,1% permaneceram abaixo e 42,5% acima da faixa adequada. Com base nestes resultados, concluímos que é importante mensurar os níveis séricos deste antimicrobiano, a fim de evitar a toxicidade e alcançar níveis adequados para o sucesso terapêutico. Palavras-chave: Vancomicina. Monitoramento de medicamentos. Bactérias gram-positivas. Infecção hospitalar ABSTRACTVancomycin is a glycopeptide antibiotic effective for gram-positive severe infections. To therapeutic effectiveness, it is necessary achieve appropriated serum levels and it requires constant monitoring since it can cause toxicity. The aim of this study was to verify the level of vancomycin serum in patients admitted to a teaching hospital in the central region of Rio Grande do Sul. This study was conducted with 69 patients, where 22 were newborns, in the period July 2012 to December 2013. Vancomycin serum levels were performed 72 hours after initiation of treatment with antimicrobial, 30 minutes before their administration, by

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Prospectively Validated Dosing Nomograms for Maximizing the Pharmacodynamics of Vancomycin Administered by Continuous Infusion in Critically Ill Patients

Cited by 111 publications

References 39 publications

Colistin and anti-Gram-positive bacterial agents against Acinetobacter baumannii

Colistin and anti-Gram-positive bacterial agents against Acinetobacter baumannii

A higher dose of vancomycin in continuous infusion is needed in critically ill patients

Avaliação Dos Níveis Séricos De Vancomicina Em Pacientes Internados Em Um Hospital De Ensino Da Região Central Do Rio Grande Do Sul

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