중환자에서의 Vancomycin 초기 혈중농도 분석
Analysis of Vancomycin Plasma Concentrations Following Initial Dosing in Critically Ill Patients
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Our study aims to analyze the effect of the initial dose of vancomycin in 146 criticallyill patients, including those with impaired kidney function, in order to determine a clinically relevantloading dose (25~30 mg/kg). From January 1, 2010 ~ May 31, 2013, vancomycin dosageschedules and plasma concentrations in ICU patients in our hospital were collected. The plasmaconcentration was predicted prior to the next dose after the initial dose of vancomycin. The concentrationat which vancomycin treatment failed was defined to be under 10 mg/l. The averageconcentration after the initial dose of vancomycin was 7.5±3.2 mg/l, which meant that only 20.5% of them reached the target concentration. Compared to the other groups, the one thatreceived over 25 mg per kg, the initial concentration was 10.4±3.1 mg/l, which translated into62.5% of them reaching the target concentration without differences in kidney function and alower mortality rate 28 days after the vancomycin dose. In conclusion, a dose greater than 25 mgvancomycin per kg of body weight is required, regardless of kidney function, in order to reachtherapeutic concentrations with only one dose prior to reaching the steady state.
Abstract
Our study aims to analyze the effect of the initial dose of vancomycin in 146 criticallyill patients, including those with impaired kidney function, in order to determine a clinically relevantloading dose (25~30 mg/kg). From January 1, 2010 ~ May 31, 2013, vancomycin dosageschedules and plasma concentrations in ICU patients in our hospital were collected. The plasmaconcentration was predicted prior to the next dose after the initial dose of vancomycin. The concentrationat which vancomycin treatment failed was defined to be under 10 mg/l. The averageconcentration after the initial dose of vancomycin was 7.5±3.2 mg/l, which meant that only 20.5% of them reached the target concentration. Compared to the other groups, the one thatreceived over 25 mg per kg, the initial concentration was 10.4±3.1 mg/l, which translated into62.5% of them reaching the target concentration without differences in kidney function and alower mortality rate 28 days after the vancomycin dose. In conclusion, a dose greater than 25 mgvancomycin per kg of body weight is required, regardless of kidney function, in order to reachtherapeutic concentrations with only one dose prior to reaching the steady state.
참고문헌 (24)
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