Sub-optimal serum gentamicin concentrations in sickle cell disease patients utilizing the Hartford protocol

Abstract

A majority of patients with SCD had sub-optimal SGC. The pharmacokinetic profile of such patients is apparently too variable to fit the existing Hartford protocol. The Hartford nomogram should be modified to address this issue. Otherwise, clinicians should revert to multiple daily dosing.

Increased vancomycin dosing requirements in sickle cell disease due to hyperfiltration-dependent and independent pathways

“…10 Our results demonstrate that the vancomycin-dosing requirement is increased by approximately 20% (0.043 vs. 0.036 gram/day/kg) in the HgbSS group to achieve a comparable drug level to HgbAA patients. Most of the vancomycin is excreted unchanged via glomerular filtration, 3 and glomerular hyperfiltration has caused increased vancomycin dosing requirements in other disease states.…”