Vol.58 No.3 May 2010
Efficacy and safety for vancomycin in uncomplicated catheter-related bloodstream infection by coagulase negative Staphylococcus
1)Department of Pharmacy, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, Japan
2)Division of Infectious Diseases, Shizuoka Cancer Center
Abstract
In the Guideline published by the Infectious Diseases Society of America(IDSA), vancomycin(VCM) treatment is recommended for catheter related bloodstream infection(CR-BSI) caused by coagulase negative Staphylococcus(CNS). The duration of VCM therapy recommended for uncomplicated CR-BSI is 5-7 days if the catheter is removed. However, CNS is not an approved indication for VCM in Japan. In addition, the efficacy, safety and necessity of TDM for VCM have not yet been validated. In this study, we retrospectively investigated the efficacy, safety and necessity of TDM for VCM in 20 patients administered a short-term course of VCM (about 7 days) for CR-BSI. The efficacy rate was 85% (17/20), the nephrotoxicity rate was 5% (1/20), and the rate of the red man syndrome was 5% (1/20). We compared the efficacy and safety of the treatment between a patient group in which TDM was undertaken and a patient group in which TDM was not performed. The treatment efficacy in the TDM and non-TDM groups was 83% (10/12) and 88% (7/8), respectively (p=1.00), the nephrotoxicity rate in the TDM and non-TDM groups was 8% (1/12) and 0% (0/8), respectively (p=1.00), and the rate of the red man syndrome in the TDM and non-TDM groups was 8% (1/12) and 0% (0/8), respectively (p=1.00). No significant difference in the efficacy or safety was found between the two groups. In conclusion, it appears that CR-BSI caused by CNS can be treated safely and effectively by VCM, and that it may be possible to omit TDM for VCM during short-term treatment of about 5-7 days for uncomplicated CR-BSI caused by CNS.
Key word
coagulase negative Staphylococcus（CNS）, catheter-related bloodstream infection（CR-BSI）, vancomycin, therapeutic drug monitoring（TDM）
Received
November 7, 2009
Accepted
April 5, 2010
Jpn. J. Chemother. 58 (3): 233-238, 2010
