Investigation of the vancomycin trough concentration in elderly patients with severe infection

CHEN Shumin; TIAN Wenyuan; BIAN Meng; ZHANG Jie

doi:10.3969/j.issn.1006-0111.2014.03.014

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Objective To investigate the vancomycin trough concentration in elderly patients with severe infection and provide references for clinical use of drugs effectively. Methods According to the Ccr of elderly patients(56 cases), who were≥65 years old, the patients were divided into two groups, one with Ccr≥50 ml/min, which named group A, the other with Ccr between 20 ml/min and 50 ml/min, which named group B. The use of vancomycin, vancomycin steady-state plasma trough concentration and the differences of renal function were analyzed before and after in both two groups. Results There were 31cases of patients in group A(25 cases of them use vancomycin 1 g,q 12 h;other 6 cases use 0.5 g,q 12 h), 25 cases of patients in group B(15 cases of them use vancomycin 1 g,q 12 h;other 10 cases use 0.5 g,q 12 h). The percentage that the trough concentration of the patients who use two different scheme of using drugs in group A was between 10 mg/L and 20 mg/L is 12%(3/25) and 66.67%(4/6).The percentage that the trough concentration of the patients who used two different scheme of using drugs in group B was between 10 mg/L and 20 mg/L is 20%(3/15) and 60%(6/10). The percentage that trough concentrationis more than 20 mg/L is 73.33 %(11/15) and 30%(3/10). The serum creatinine value of the 15 patients of all cases except for group B of which vancomycin dosage was 1 g, q 12 h had significantly risen after using the drug(P<0.05). The urea nitrogen had no obvious change (P>0.05). The serum creatinine value and urea nitrogen of other patients had no significant change after using the drug (P>0.05). Group B had kidney toxicities observed in 5 patients, the dosage of vancomycin was 1 g, q 12 h, valley concentration>30 mg/L. There was no kidney toxicities observed in group A. Conclusion The use of vancomycin in elderly patients must depend on their Ccr. If the Ccr was larger than 50 ml/min, the use of vancomycin should be 1 g,q 12 h, and the Ccr was between 20 ml/min and 50 ml/min, the use should be 0.5 g. In addition, blood trough concentration need to be paid more attention in elderly patients in order to regulate the regimens according to the individual differences.

Investigation of the vancomycin trough concentration in elderly patients with severe infection

Fuxing Hospital, Capital Medical University, Beijing, 100038 China

Received Date: 2013-04-08

Rev Recd Date: 2013-11-28

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Abstract: Objective To investigate the vancomycin trough concentration in elderly patients with severe infection and provide references for clinical use of drugs effectively. Methods According to the Ccr of elderly patients(56 cases), who were≥65 years old, the patients were divided into two groups, one with Ccr≥50 ml/min, which named group A, the other with Ccr between 20 ml/min and 50 ml/min, which named group B. The use of vancomycin, vancomycin steady-state plasma trough concentration and the differences of renal function were analyzed before and after in both two groups. Results There were 31cases of patients in group A(25 cases of them use vancomycin 1 g,q 12 h;other 6 cases use 0.5 g,q 12 h), 25 cases of patients in group B(15 cases of them use vancomycin 1 g,q 12 h;other 10 cases use 0.5 g,q 12 h). The percentage that the trough concentration of the patients who use two different scheme of using drugs in group A was between 10 mg/L and 20 mg/L is 12%(3/25) and 66.67%(4/6).The percentage that the trough concentration of the patients who used two different scheme of using drugs in group B was between 10 mg/L and 20 mg/L is 20%(3/15) and 60%(6/10). The percentage that trough concentrationis more than 20 mg/L is 73.33 %(11/15) and 30%(3/10). The serum creatinine value of the 15 patients of all cases except for group B of which vancomycin dosage was 1 g, q 12 h had significantly risen after using the drug(P<0.05). The urea nitrogen had no obvious change (P>0.05). The serum creatinine value and urea nitrogen of other patients had no significant change after using the drug (P>0.05). Group B had kidney toxicities observed in 5 patients, the dosage of vancomycin was 1 g, q 12 h, valley concentration>30 mg/L. There was no kidney toxicities observed in group A. Conclusion The use of vancomycin in elderly patients must depend on their Ccr. If the Ccr was larger than 50 ml/min, the use of vancomycin should be 1 g,q 12 h, and the Ccr was between 20 ml/min and 50 ml/min, the use should be 0.5 g. In addition, blood trough concentration need to be paid more attention in elderly patients in order to regulate the regimens according to the individual differences.

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Reference (10)

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Investigation of the vancomycin trough concentration in elderly patients with severe infection

doi: 10.3969/j.issn.1006-0111.2014.03.014

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