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Abstract

Vol.58 No.2 March 2010

Therapeutic drug monitoring survey of anti-MRSA agents in Japan

Masahiro Kobayashi, Yoshio Takesue, Yusuke Tanigawara, Hiroshige Mikamo, Toshimi Kimura, Sumio Hirata, Tadashi Shiraishi, Toshiyuki Sakaeda and Shunji Takakura

Working group for therapeutic drug monitoring standardization of antibiotics, Infectious Disease Chemotherapy Pharmacist Committee, the Japanese Society of Chemotherapy, Nichinai Kaikan B1, 3-28-8 Hongo, Bunkyo-ku, Tokyo, Japan

Abstract

We distributed questionnaires to determine therapeutic drug monitoring(TDM) status for anti-MRSA agents vancomycin(VCM), teicoplanin(TEIC), and arbekacin(ABK) in 563 Japanese hospitals having pharmacists enrolled in the Japanese Society of Chemotherapy. Responses were collected from 302 (53.6%) institutions. In over 80% of facilities, pharmacists provide clinical consultation on anti-MRSA agents based on TDM. General recommendations for monitoring serum drugs concentrations are as follows: (1) VCM, trough concentration on day 3 targeting >10 μg/mL; (2) TEIC, on day 4 targeting >15 μg/mL; and (3) ABK, on day 3 targeting <2 μg/mL and peak >9 μg/mL. Answers for main questions such as sample timing, sampling points, and targeted concentrations, were roughly equivalent to our recommendations. Standardizing TDM involves problems including large inter institutional differences in ABK TDM and no claim of rights to cost monitoring more than twice a month under the current government-run health insurance system.

Key word

therapeutic drug monitoring, vancomycin, teicoplanin, arbekacin, questionnaire

Received

January 20, 2010

Accepted

February 4, 2010

Jpn. J. Chemother. 58 (2): 119-124, 2010