Vol.64 No.6 November 2016
Influence on vancomycin daily doses, treatment periods, total doses, and renal dysfunction rates with the introduction of the therapeutic drug monitoring guidelines for antimicrobial drugs
1)Department of Pharmacy, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku, Kokurakita-ku, Kitakyushu, Fukuoka, Japan
2)Department of General Medicine, Kitakyushu Municipal Medical Center
3)Graduate School of Biomedical Sciences, Nagasaki University
Abstract
Target vancomycin trough concentrations of 10-20 μg/mL are suggested in the therapeutic drug monitoring (TDM) guidelines for antimicrobial drugs. We had previously set the target vancomycin trough concentrations at 10-15 μg/mL before the announcement of the TDM guidelines, but changed them to 10-20 μg/mL in our hospital after the announcement. In this study, to examine the influence on the efficacy and safety of vancomycin following the adoption of the TDM guidelines, we carried out a comparison before and after the introduction of the TDM guidelines regarding the vancomycin daily doses, treatment periods, total doses, and renal dysfunction rates in 171 patients who received vancomycin. Our results demonstrated that the vancomycin daily doses before and after the TDM guidelines were 1.5 g (median) and 2.0 g, the treatment periods 12.5 days and 10.0 days (P=0.042), the total doses 16.25 g and 14.0 g, and the renal dysfunction rates 25.2% and 23.2%, respectively. These results suggest that the target vancomycin trough concentrations of 10-20 μg/mL based on the TDM guidelines resulted in a significantly shorter treatment period and were not associated with any increase in renal dysfunction: thus, the introduction of the TDM guidelines may be useful.
Key word
vancomycin, therapeutic drug monitoring, guideline, blood concentration, renal dysfunction
Received
March 2, 2016
Accepted
July 13, 2016
Jpn. J. Chemother. 64 (6): 813-816, 2016
