Target serum concentration of vancomycin may be reached earlier with a loading dose
Abstract. Background:. Vancomycin treatment failure against vancomycin-susceptible gram-positive cocci is not rare in the intensive care unit (ICU). One of the reasons for this is the substandard drug trough concentration. We aimed to examine the hypothesis that the target serum concentration could...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2022-02-01
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| Series: | Chinese Medical Journal |
| Online Access: | http://journals.lww.com/10.1097/CM9.0000000000001905 |
| _version_ | 1830409480946319360 |
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| author | Yanxia Huang Le He Yunxin Deng Renjing Zhang Mei Meng Jiao Liu Dechang Chen Peng Lyu |
| author_facet | Yanxia Huang Le He Yunxin Deng Renjing Zhang Mei Meng Jiao Liu Dechang Chen Peng Lyu |
| author_sort | Yanxia Huang |
| collection | DOAJ |
| description | Abstract. Background:. Vancomycin treatment failure against vancomycin-susceptible gram-positive cocci is not rare in the intensive care unit (ICU). One of the reasons for this is the substandard drug trough concentration. We aimed to examine the hypothesis that the target serum concentration could be reached earlier with a loading dose of vancomycin.
Methods:. This retrospective cohort study was conducted at our ICU between June 2018 and June 2020 and involved patients who were suspected of having, or confirmed to have, gram-positive cocci infection and treated with vancomycin. One group of the patients was administered a loading dose of vancomycin (loading group) and compared with the group that did not receive a loading dose (control group). The baseline characteristics, vancomycin serum concentrations, and clinical outcomes were collected and analyzed.
Results:. Fifty-five patients were finally included, of which 29 received a loading dose of vancomycin. The serum concentration of vancomycin before the second dose was significantly higher for the loading group than for the control group (10.3 ± 6.1 mg/L vs. 5.7 ± 4.4 mg/L, P = 0.002). The results for both groups were similar before the fifth dose (12.4 ± 7.3 mg/L vs. 10.3 ± 6.3 mg/L in the loading and the control groups, respectively; P = 0.251). The 28-day mortality was lower for the loading group than for the control group (6.7% vs. 34.6% in the loading and control groups, respectively; P = 0.026). No significant differences were observed in serum creatinine (Cr) concentrations of the two groups.
Conclusion:. With the loading dose of vancomycin, the target serum concentration of vancomycin may be reached earlier without increasing the risk of acute kidney injury.
Trial registration:. https://www.chictr.org.cn; ChiCTR2000035369 |
| first_indexed | 2024-12-20T19:14:09Z |
| format | Article |
| id | doaj.art-337091842ad04f7dbcb7d174c539beb5 |
| institution | Directory Open Access Journal |
| issn | 0366-6999 2542-5641 |
| language | English |
| last_indexed | 2024-12-20T19:14:09Z |
| publishDate | 2022-02-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Chinese Medical Journal |
| spelling | doaj.art-337091842ad04f7dbcb7d174c539beb52022-12-21T19:29:09ZengWolters KluwerChinese Medical Journal0366-69992542-56412022-02-01135331732310.1097/CM9.0000000000001905202202050-00010Target serum concentration of vancomycin may be reached earlier with a loading doseYanxia HuangLe HeYunxin DengRenjing ZhangMei MengJiao LiuDechang ChenPeng LyuAbstract. Background:. Vancomycin treatment failure against vancomycin-susceptible gram-positive cocci is not rare in the intensive care unit (ICU). One of the reasons for this is the substandard drug trough concentration. We aimed to examine the hypothesis that the target serum concentration could be reached earlier with a loading dose of vancomycin. Methods:. This retrospective cohort study was conducted at our ICU between June 2018 and June 2020 and involved patients who were suspected of having, or confirmed to have, gram-positive cocci infection and treated with vancomycin. One group of the patients was administered a loading dose of vancomycin (loading group) and compared with the group that did not receive a loading dose (control group). The baseline characteristics, vancomycin serum concentrations, and clinical outcomes were collected and analyzed. Results:. Fifty-five patients were finally included, of which 29 received a loading dose of vancomycin. The serum concentration of vancomycin before the second dose was significantly higher for the loading group than for the control group (10.3 ± 6.1 mg/L vs. 5.7 ± 4.4 mg/L, P = 0.002). The results for both groups were similar before the fifth dose (12.4 ± 7.3 mg/L vs. 10.3 ± 6.3 mg/L in the loading and the control groups, respectively; P = 0.251). The 28-day mortality was lower for the loading group than for the control group (6.7% vs. 34.6% in the loading and control groups, respectively; P = 0.026). No significant differences were observed in serum creatinine (Cr) concentrations of the two groups. Conclusion:. With the loading dose of vancomycin, the target serum concentration of vancomycin may be reached earlier without increasing the risk of acute kidney injury. Trial registration:. https://www.chictr.org.cn; ChiCTR2000035369http://journals.lww.com/10.1097/CM9.0000000000001905 |
| spellingShingle | Yanxia Huang Le He Yunxin Deng Renjing Zhang Mei Meng Jiao Liu Dechang Chen Peng Lyu Target serum concentration of vancomycin may be reached earlier with a loading dose Chinese Medical Journal |
| title | Target serum concentration of vancomycin may be reached earlier with a loading dose |
| title_full | Target serum concentration of vancomycin may be reached earlier with a loading dose |
| title_fullStr | Target serum concentration of vancomycin may be reached earlier with a loading dose |
| title_full_unstemmed | Target serum concentration of vancomycin may be reached earlier with a loading dose |
| title_short | Target serum concentration of vancomycin may be reached earlier with a loading dose |
| title_sort | target serum concentration of vancomycin may be reached earlier with a loading dose |
| url | http://journals.lww.com/10.1097/CM9.0000000000001905 |
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