The effect of body mass index and creatinine clearance on serum trough concentration of vancomycin in adult patients
Abstract Background The aim of this study was to evaluate the influence of patient body mass index (BMI) and estimated creatinine clearance (CrCl) on serum vancomycin concentrations to define a possible optimal dosage regimen in overweight patients based on data obtained during therapeutic drug moni...
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| Format: | Article |
| Language: | English |
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BMC
2020-05-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | http://link.springer.com/article/10.1186/s12879-020-05067-7 |
| _version_ | 1828902221230637056 |
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| author | Yuyan Pan Xiaomei He Xinyu Yao Xiaofeng Yang Fengjiao Wang Xinyuan Ding Wenjuan Wang |
| author_facet | Yuyan Pan Xiaomei He Xinyu Yao Xiaofeng Yang Fengjiao Wang Xinyuan Ding Wenjuan Wang |
| author_sort | Yuyan Pan |
| collection | DOAJ |
| description | Abstract Background The aim of this study was to evaluate the influence of patient body mass index (BMI) and estimated creatinine clearance (CrCl) on serum vancomycin concentrations to define a possible optimal dosage regimen in overweight patients based on data obtained during therapeutic drug monitoring. Methods This retrospective study used data collected from January 2017 to January 2019. Adult patients (n = 204) received vancomycin treatment at a dose of 1000 mg every 12 h and underwent serum monitoring. Data collected included patient disease category, sex, age, height, weight, vancomycin concentrations, and serum creatinine. The CrCl values were estimated using the Cockcroft-Gault formula. In this study, statistical comparisons were performed on the results of patients according to serum vancomycin concentration. Results Serum vancomycin concentration was significantly related to BMI (P < 0.001) and CrCl (P < 0.05) in adult patients. Furthermore, the trough serum vancomycin concentration showed a logarithmic correlation with BMI (R = − 0.5108, 95% CI: − 0.6082 to − 0.3982, P < 0.001) and CrCl (R = − 0.5739, 95% CI: − 0.6616 to − 0.4707, P < 0.001). The multivariate analysis showed that BMI and CrCl are independent contributors to the trough vancomycin concentration. Moreover, some of the patients with higher BMI (≥ 24 kg/m2) met the goal trough concentration after an adjustment from 1000 mg every 12 h to 1000 mg every 8 h. Conclusions Serum vancomycin concentration decreases progressively with increasing BMI and the augmentation in CrCl in adult patients. The trough concentration of vancomycin should be continuously monitored for patients with a BMI ≥ 24 kg/m2, and the dosage regimen should be adjusted to reach the target trough concentration in these patients to reduce the impact of BMI. |
| first_indexed | 2024-12-13T16:12:39Z |
| format | Article |
| id | doaj.art-94eb98702de548de95ac9f4595a1c9a5 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-13T16:12:39Z |
| publishDate | 2020-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-94eb98702de548de95ac9f4595a1c9a52022-12-21T23:38:54ZengBMCBMC Infectious Diseases1471-23342020-05-012011710.1186/s12879-020-05067-7The effect of body mass index and creatinine clearance on serum trough concentration of vancomycin in adult patientsYuyan Pan0Xiaomei He1Xinyu Yao2Xiaofeng Yang3Fengjiao Wang4Xinyuan Ding5Wenjuan Wang6Department of Pharmacy, the Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical UniversityDepartment of Pharmacy, the Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical UniversityDepartment of Gastroenterology, the Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical UniversityDepartment of neonatology, Children’s Hospital of Soochow UniversityDepartment of Pharmacy, Children’s Hospital of Soochow UniversityDepartment of Pharmacy, The Affiliated Suzhou Hospital of Nanjing Medical UniversityDepartment of Pharmacy, Children’s Hospital of Soochow UniversityAbstract Background The aim of this study was to evaluate the influence of patient body mass index (BMI) and estimated creatinine clearance (CrCl) on serum vancomycin concentrations to define a possible optimal dosage regimen in overweight patients based on data obtained during therapeutic drug monitoring. Methods This retrospective study used data collected from January 2017 to January 2019. Adult patients (n = 204) received vancomycin treatment at a dose of 1000 mg every 12 h and underwent serum monitoring. Data collected included patient disease category, sex, age, height, weight, vancomycin concentrations, and serum creatinine. The CrCl values were estimated using the Cockcroft-Gault formula. In this study, statistical comparisons were performed on the results of patients according to serum vancomycin concentration. Results Serum vancomycin concentration was significantly related to BMI (P < 0.001) and CrCl (P < 0.05) in adult patients. Furthermore, the trough serum vancomycin concentration showed a logarithmic correlation with BMI (R = − 0.5108, 95% CI: − 0.6082 to − 0.3982, P < 0.001) and CrCl (R = − 0.5739, 95% CI: − 0.6616 to − 0.4707, P < 0.001). The multivariate analysis showed that BMI and CrCl are independent contributors to the trough vancomycin concentration. Moreover, some of the patients with higher BMI (≥ 24 kg/m2) met the goal trough concentration after an adjustment from 1000 mg every 12 h to 1000 mg every 8 h. Conclusions Serum vancomycin concentration decreases progressively with increasing BMI and the augmentation in CrCl in adult patients. The trough concentration of vancomycin should be continuously monitored for patients with a BMI ≥ 24 kg/m2, and the dosage regimen should be adjusted to reach the target trough concentration in these patients to reduce the impact of BMI.http://link.springer.com/article/10.1186/s12879-020-05067-7Therapeutic drug monitoringVancomycinBody mass indexCreatinine clearance |
| spellingShingle | Yuyan Pan Xiaomei He Xinyu Yao Xiaofeng Yang Fengjiao Wang Xinyuan Ding Wenjuan Wang The effect of body mass index and creatinine clearance on serum trough concentration of vancomycin in adult patients BMC Infectious Diseases Therapeutic drug monitoring Vancomycin Body mass index Creatinine clearance |
| title | The effect of body mass index and creatinine clearance on serum trough concentration of vancomycin in adult patients |
| title_full | The effect of body mass index and creatinine clearance on serum trough concentration of vancomycin in adult patients |
| title_fullStr | The effect of body mass index and creatinine clearance on serum trough concentration of vancomycin in adult patients |
| title_full_unstemmed | The effect of body mass index and creatinine clearance on serum trough concentration of vancomycin in adult patients |
| title_short | The effect of body mass index and creatinine clearance on serum trough concentration of vancomycin in adult patients |
| title_sort | effect of body mass index and creatinine clearance on serum trough concentration of vancomycin in adult patients |
| topic | Therapeutic drug monitoring Vancomycin Body mass index Creatinine clearance |
| url | http://link.springer.com/article/10.1186/s12879-020-05067-7 |
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