New recommendations for vancomycin dosage for patients with MRSA pneumonia with various degrees of renal function impairment. 2005

Makiko Yoshida, and Noriko Yasuda, and Mayumi Nishikata, and Kanami Okamoto, and Takahiro Uchida, and Kenji Matsuyama
Pharmacy Department, Satsukikai Aoyama Second Hospital, Kawachinagano, Osaka, Japan. makiko24@osk3.3web.ne.jp

New recommendations for vancomycin (VCM) dosages and dosing intervals for MRSA-infected pneumonia patients with various degrees of renal function impairment were established based on Japanese population pharmacokinetic parameters proposed by Yasuhara et al. in 1998. Based on individual creatinine clearance (CLcr), we proposed the optimum VCM dosages and dosing intervals so that the peak level of VCM (level at 1 h after the end of infusion) is maintained in the range of 25-40 microg/ml and the trough level is kept under 15 microg/ml. The recommended doses and intervals of VCM were as follows: 20 mg/kg every 12 h for CLcr of 80-100 ml/min, 18 mg/kg every 12 h for CLcr of 70 ml/min, 25 mg/kg every 24 h for CLcr of 50-60 ml/min, 22 mg/kg every 36 h for CLcr of 40 ml/min, and 18 mg/kg every 48 h for CLcr of 30 ml/min. Using the recorded pharmacokinetic parameters of VCM from eight patients with pneumonia who were admitted to Aoyama Second Hospital between November 1997 and January 2002, these recommendations were used in computer simulations for the eight patients, and the usefulness of these recommendations was confirmed.

UI MeSH Term Description Entries
D007674 Kidney Diseases Pathological processes of the KIDNEY or its component tissues. Disease, Kidney,Diseases, Kidney,Kidney Disease
D008297 Male Males
D011023 Pneumonia, Staphylococcal Pneumonia caused by infections with bacteria of the genus STAPHYLOCOCCUS, usually with STAPHYLOCOCCUS AUREUS. Staphylococcal Pneumonia,Staphylococcus Aureus Pneumonia,Pneumonia, Staphylococcus Aureus,Pneumonias, Staphylococcal,Pneumonias, Staphylococcus Aureus,Staphylococcal Pneumonias,Staphylococcus Aureus Pneumonias
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D013211 Staphylococcus aureus Potentially pathogenic bacteria found in nasal membranes, skin, hair follicles, and perineum of warm-blooded animals. They may cause a wide range of infections and intoxications.
D014640 Vancomycin Antibacterial obtained from Streptomyces orientalis. It is a glycopeptide related to RISTOCETIN that inhibits bacterial cell wall assembly and is toxic to kidneys and the inner ear. AB-Vancomycin,Diatracin,VANCO-cell,Vanco Azupharma,Vanco-saar,Vancocin,Vancocin HCl,Vancocine,Vancomicina Abbott,Vancomicina Chiesi,Vancomicina Combino Phar,Vancomicina Norman,Vancomycin Hexal,Vancomycin Hydrochloride,Vancomycin Lilly,Vancomycin Phosphate (1:2),Vancomycin Phosphate (1:2), Decahydrate,Vancomycin Sulfate,Vancomycin-ratiopharm,Vancomycine Dakota,Hydrochloride, Vancomycin,Sulfate, Vancomycin
D016106 Methicillin Resistance Non-susceptibility of a microbe to the action of METHICILLIN, a semi-synthetic penicillin derivative. Methicillin-Resistant,Methicillin Resistant,Resistance, Methicillin

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