혈액투석 환자에서 적절한 Vancomycin 용법, 용량
Vancomycin Dosage in Hemodialysis Patients
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초록
Purpose : This study was undertaken to find an appropriate vancomycin dosage for patients who had undergone hemodialysis. Methods : We retrospectively reviewed the medical records of patients who had undergone hemodialysis and were administered i.v vancomycin between 1st Jan, 2014 to 30th Jun, 2016. The association between vancomycin dosage, serum trough concentrations and hemodialysis were further evaluated. Results : Only 18(26.9%) serum samples achieved the therapeutic range; 16(23.9%) were complicated infections, and 2(3.0%) were simple infections. Most patients’serum concentrations were under the therapeutic range. Frequency of hemodialysis and vancomycin dosage had an effect on the serum concentrations. Totally, 32 patients with complicated infections had undergone hemodialysis three times per week. Serum concentration of 14(43.8%) patients achieved the therapeutic range, of which 10(42.8%) patients were administered i.v vancomycin 15~20 mg/kg, every 3 or 4 days. Of the 49 patients who had undergone hemodialysis three times per week, the serum concentration of only 9(18.4%) patients was under 10 mg/L. Conclusion : We recommend an i.v vancomycin dosage of 15~20 mg/kg, every 3 or 4 days, to treat patients undergoing regular hemodialysis, who present with complicated infections. However, further evaluation of the vancomycin dosage in hemodialysis patents should be performed, to confirm the appropriacy of the recommendation.
Abstract
Purpose : This study was undertaken to find an appropriate vancomycin dosage for patients who had undergone hemodialysis. Methods : We retrospectively reviewed the medical records of patients who had undergone hemodialysis and were administered i.v vancomycin between 1st Jan, 2014 to 30th Jun, 2016. The association between vancomycin dosage, serum trough concentrations and hemodialysis were further evaluated. Results : Only 18(26.9%) serum samples achieved the therapeutic range; 16(23.9%) were complicated infections, and 2(3.0%) were simple infections. Most patients’serum concentrations were under the therapeutic range. Frequency of hemodialysis and vancomycin dosage had an effect on the serum concentrations. Totally, 32 patients with complicated infections had undergone hemodialysis three times per week. Serum concentration of 14(43.8%) patients achieved the therapeutic range, of which 10(42.8%) patients were administered i.v vancomycin 15~20 mg/kg, every 3 or 4 days. Of the 49 patients who had undergone hemodialysis three times per week, the serum concentration of only 9(18.4%) patients was under 10 mg/L. Conclusion : We recommend an i.v vancomycin dosage of 15~20 mg/kg, every 3 or 4 days, to treat patients undergoing regular hemodialysis, who present with complicated infections. However, further evaluation of the vancomycin dosage in hemodialysis patents should be performed, to confirm the appropriacy of the recommendation.
참고문헌 (12)
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