Vancomycin: An Update

Cheung, Richard P. F.; DiPiro, Joseph T.

doi:10.1002/j.1875-9114.1986.tb03471.x

Cited by 73 publications

(26 citation statements)

References 167 publications

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“…for preterm infants. However, the observed variation in our data was not unexpected considering the drug's dependence upon Body weight (Kg) renal function for body elimination (21,22) and the ontogeny Fig. 2.…”

Section: Resultsmentioning

confidence: 52%

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The Clinical Pharmacology of Vancomycin in Seriously Ill Preterm Infants

et al. 1987

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ABSTRACT. The first dose and steady state pharmacokinetics of vancomycin were studied in 16 seriously ill preterm infants (534 wk gestational age) with documented Staphylococcus epidermidis infections. One infant was dropped from the study due to peripheral flushing occurring during administration of the first dose. Individual vancomycin doses ranged from 9.8 to 17.8 mg/kg and were infused intravenously over 15-37 min. Fifteen infants were studied after the first dose of vancomycin, whereas only 12 of these 15 were able to be studied under steady state conditions. Vancomycin half-life, steady-state volume of distribution, and body clearance averaged 6.0 h, 0.53 liter/ kg, and 1.22 ml/min after the first dose and only slight differences were observed in these parameter estimates under steady state conditions. However, substantial accumulation of vancomycin in serum was observed with multiple dosing. Complete 8-h urine collections were possible in 12 of 15 premature infants after the first dose of vancomycin. Overall, 44.6% of the dose was recovered in the urine with a corresponding vancomycin renal CIR averaging 0.88 ml/min. Vancomycin body C1 correlated directly with renal CIR ( r = 0.88, p < 0.001) and body weight ( r = 0.8, p < 0.001). Vancomycin pharmacokinetic parameter estimates Vdss and C1 correlated directly with body weight, surface area, and postconceptional age. No significant relationships were observed between these parameter estimates and gestational age or postnatal age. Fourteen of 15 infants were treated successfully for their underlying infectious process. These data support the use of lower doses of vancomycin than previously recommended for the treatment of preterm infants. (Pediatr Res 22: 360-363, 1987) Abbreviations AUC, area under the serum concentration time curve tsl2, half-life C1, body clearance Vdss, steady state volume of distribution CI,, renal clearance AUMC, area under the moment curve T, infusion duration

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Section: Resultsmentioning

confidence: 52%

“…1). For infants more than 8 days of age, 8-h steady state vancomycin trough concentrations were 2-to 4-fold greater than currently recommended for the treatment of staphylococcal infections (8,9,14,21,22).…”

Section: Resultsmentioning

confidence: 79%

The Clinical Pharmacology of Vancomycin in Seriously Ill Preterm Infants

et al. 1987

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“…Samples were collected before infusion, at the end of infusion, and at 0.5 and 1 h after the second 1-g and the third 500-mg doses. For the last dose of each regimen, blood was collected before infusion, at the end of infusion, and at 0.08, 0.25, 0.5, 1, 1.5, 2, 2.5, 3,4,6,8,12,16,24,30, and 36 h after completion of the infusion. The exact sampling times were recorded and used in the All samples were assayed for vancomycin concentrations within 2 weeks of collection by a fluorescence polarization immunoassay procedure (TDx; Abbott Laboratories, Diagnostics Division, Irving, Tex.).…”

Section: Methodsmentioning

confidence: 99%

Comparison of steady-state pharmacokinetics of two dosage regimens of vancomycin in normal volunteers

Healy¹,

Polk²,

Garson³

et al. 1987

Antimicrob Agents Chemother

117

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A pharmacokinetic comparison of the two recommended dosages of vancomycin given as multiple doses has not been previously performed. Eleven adult subjects with normal renal function randomly received 500 mg every 6 h (five doses) and, later, 1,000 mg every 12 h (three doses). Each dose was infused over 1 h, and regimens were separated by 1 week. Compared with the two-compartment fit, a three-compartment fit significantly reduced the residual weighted sums of squares. Accumulation occurred for both regimens after repeated dosing and was independent of dose. At steady state, concentrations in serum at 1 h showed little variation for the 1,000- or the 500-mg dose regimen (33.7 +/- 3.8 versus 22.6 +/- 3.2 micrograms/ml); trough concentrations were 7.9 +/- 1.7 versus 11.2 +/- 2.2 micrograms/ml, respectively. With the 1,000-mg dose, the terminal half-life was 7.7 +/- 1.8 h, steady-state area under the curve for the dose interval was 227 +/- 28.3 micrograms X h/ml, and total body clearance was 86.1 +/- 8.9 ml/min per 1.73 m2. The red-man syndrome occurred in 9 of 11 volunteers who received 1,000-mg doses and in none of those who received 500-mg doses. We concluded that vancomycin disposition in healthy adults with normal renal function is best described by a three-compartment model, there is relatively little variation in vancomycin disposition in normal volunteers, significant accumulation occurs with multiple dosing, it is inappropriate to use the same therapeutic window for both regimens, and the pharmacokinetics of vancomycin justify a 12-h dose interval; however, a 1-g dose is associated with a significantly greater incidence of the red-man syndrome.

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“…It shows a high antibacterial activity against Staphylococcus aureus and other Staphylococcus species. [1][2][3] Vancomycin hydrochloride is considered for the treatment of septicimia, lower respiratory tract, skin, and bone infections caused by gram positive bacteria. Vancomycin hydrochloride is reported to be effective at a minimum inhibitory concentration of 2 μg/mL against methicillin-resistant Staphylococcus aureus (MRSA).…”

Section: Introductionmentioning

confidence: 99%

Design and Development of Vancomycin Liposomes

Srinivas¹,

Tenneti²,

Nimmali³

2015

IJPER

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Vancomycin hydrochloride is water soluble and poorly absorbable glycopeptide antibiotic act by inhibition of the synthesis of peptidoglycan a major component of bacteria cell wall. It is highly effective against the Staphylococcus aureus and other Staphylococcus species microorganisms. Structurally vancomycin hydrochloride has six peptide bonds with a molecular weight of approximately 1500 Da. Liposomes, the colloidal vesicular structures due to their biphasic environment can act as carriers for both lipophilic & hydrophilic drugs. The encapsulation of antimicrobials in liposomes potentially offers enhanced pharmacokinetics and pharmacodynamics and decreased toxicity. This delivery system has the advantages of targeted, long circulation, low toxicity, sustained-release, no immunogenicity and protecting the encapsulated drugs from the destructive action of the external media. The present research work is planned to develop liposomal formulation of Vancomycin hydrochloride and to study the possibility of permeability enhancement. Liposomes are prepared by using various permeation enhancers like propylene glycol, poly ethylene glycol 400, poly ethylene glycol 600, Tween 80 and Span 60. The prepared liposomes are characterized by optical microscopy, scanning electron microscopy, particle size determination, encapsulation efficiency, FTIR spectroscopy studies and in vitro diffusion studies using dialysis membrane. Among six different liposomes F2 formulation (containing propylene glycol) has showed promising results with respect to drug entrapment and percentage drug release.

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Vancomycin: An Update

Cited by 73 publications

References 167 publications

The Clinical Pharmacology of Vancomycin in Seriously Ill Preterm Infants

The Clinical Pharmacology of Vancomycin in Seriously Ill Preterm Infants

Comparison of steady-state pharmacokinetics of two dosage regimens of vancomycin in normal volunteers

Design and Development of Vancomycin Liposomes

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