Vancomycin Pharmacokinetic Parameters in Patients Undergoing Hematopoietic Stem Cell Transplantation (HSCT)
Background: Vancomycin is used abundantly in patients undergoing HSCT, especially during neutropenic fever. Despite its widespread use little is known about vancomycin pharmacokinetics in HSCT patients. We conducted this study to investigate vancomycin pharmacokinetic parameters in our HSCT patient...
Main Authors: | , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Tehran University of Medical Sciences
2013-12-01
|
Series: | International Journal of Hematology-Oncology and Stem Cell Research |
Subjects: | |
Online Access: | https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/443 |
id |
doaj-97159107e16b4784a44dda9f281e7995 |
---|---|
record_format |
Article |
spelling |
doaj-97159107e16b4784a44dda9f281e79952020-11-25T04:02:15ZengTehran University of Medical SciencesInternational Journal of Hematology-Oncology and Stem Cell Research2008-22072013-12-0174429Vancomycin Pharmacokinetic Parameters in Patients Undergoing Hematopoietic Stem Cell Transplantation (HSCT)Maryam Taghizadeh Ghehi0Saeed Rezaee1Alireza Hayatshahi2Molouk Hadjibabaie3Kheirollah Gholami4Mohammadreza Javadi5Seyed Hamid Khoee6Mania Radfar7Mohsen Esfandbod8Ardeshir Ghavamzadeh9Research Center for Rational Use of Drugs, Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.Department of Pharmaceutics, Faculty of Pharmacy, Ahvaz University of Medical Sciences, Ahvaz, Iran.Clinical Pharmacy Department, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.Research Center for Rational Use of Drugs, Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.Research Center for Rational Use of Drugs, Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.Research Center for Rational Use of Drugs, Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.Clinical Pharmacy Department, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.Clinical Pharmacy Department, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.Hematology-Oncology and SCT Research Centre, Department of Hematology-Oncology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.Hematology-Oncology and SCT Research Centre, Department of Hematology-Oncology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Background: Vancomycin is used abundantly in patients undergoing HSCT, especially during neutropenic fever. Despite its widespread use little is known about vancomycin pharmacokinetics in HSCT patients. We conducted this study to investigate vancomycin pharmacokinetic parameters in our HSCT patients and to evaluate current dosing regimen based on trough vancomycin concentrations measurement. Methods: Vancomycin serum concentration at steady-state was determined prospectively in 46 adult HSCT patients who received vancomycin as empirical treatment of neutropenic fever. Individual steady-steady pharmacokinetic parameters were also determined in 20 patients who had two vancomycin levels from an administered dose, assuming one-compartment model. Acute kidney injury was also evaluated in our patients during vancomycin therapy. Results: Mean (±SD) apparent volume of distribution (L/kg) and clearance (mL/min) were 0.6 (± 0.33) and 109.7 (± 57.5) respectively. With mean (±SD) total daily dose of vancomycin 31.9 (±10.5) mg/kg/day that was administered, more than 90 % of measured vancomycin trough concentrations were outside the range of 15-20 mg/L and 54.3% of patients had trough concentrations below 10 mg/L. Of 46 patients, 21 patients (45.7%) developed acute kidney injury (AKI) during vancomycin therapy; among them 19 patients were receiving nephrotoxic drug(s) concomitantly. Conclusion: Current vancomycin dosage regimen could not lead to recommended therapeutic serum concentrations in our patients. Large variation in vancomycin pharmacokinetic parameters observed among patients of this study along with difference of vancomycin pharmacokinetics in our study and other similar studies further explain the need for therapeutic drug monitoring and individualization of vancomycin dosing. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/443Hematopoietic stem cell transplantationNeutropenic feverPharmacokinetic parametersVancomycin |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Maryam Taghizadeh Ghehi Saeed Rezaee Alireza Hayatshahi Molouk Hadjibabaie Kheirollah Gholami Mohammadreza Javadi Seyed Hamid Khoee Mania Radfar Mohsen Esfandbod Ardeshir Ghavamzadeh |
spellingShingle |
Maryam Taghizadeh Ghehi Saeed Rezaee Alireza Hayatshahi Molouk Hadjibabaie Kheirollah Gholami Mohammadreza Javadi Seyed Hamid Khoee Mania Radfar Mohsen Esfandbod Ardeshir Ghavamzadeh Vancomycin Pharmacokinetic Parameters in Patients Undergoing Hematopoietic Stem Cell Transplantation (HSCT) International Journal of Hematology-Oncology and Stem Cell Research Hematopoietic stem cell transplantation Neutropenic fever Pharmacokinetic parameters Vancomycin |
author_facet |
Maryam Taghizadeh Ghehi Saeed Rezaee Alireza Hayatshahi Molouk Hadjibabaie Kheirollah Gholami Mohammadreza Javadi Seyed Hamid Khoee Mania Radfar Mohsen Esfandbod Ardeshir Ghavamzadeh |
author_sort |
Maryam Taghizadeh Ghehi |
title |
Vancomycin Pharmacokinetic Parameters in Patients Undergoing Hematopoietic Stem Cell Transplantation (HSCT) |
title_short |
Vancomycin Pharmacokinetic Parameters in Patients Undergoing Hematopoietic Stem Cell Transplantation (HSCT) |
title_full |
Vancomycin Pharmacokinetic Parameters in Patients Undergoing Hematopoietic Stem Cell Transplantation (HSCT) |
title_fullStr |
Vancomycin Pharmacokinetic Parameters in Patients Undergoing Hematopoietic Stem Cell Transplantation (HSCT) |
title_full_unstemmed |
Vancomycin Pharmacokinetic Parameters in Patients Undergoing Hematopoietic Stem Cell Transplantation (HSCT) |
title_sort |
vancomycin pharmacokinetic parameters in patients undergoing hematopoietic stem cell transplantation (hsct) |
publisher |
Tehran University of Medical Sciences |
series |
International Journal of Hematology-Oncology and Stem Cell Research |
issn |
2008-2207 |
publishDate |
2013-12-01 |
description |
Background: Vancomycin is used abundantly in patients undergoing HSCT, especially during neutropenic fever. Despite its widespread use little is known about vancomycin pharmacokinetics in HSCT patients. We conducted this study to investigate vancomycin pharmacokinetic parameters in our HSCT patients and to evaluate current dosing regimen based on trough vancomycin concentrations measurement.
Methods: Vancomycin serum concentration at steady-state was determined prospectively in 46 adult HSCT patients who received vancomycin as empirical treatment of neutropenic fever. Individual steady-steady pharmacokinetic parameters were also determined in 20 patients who had two vancomycin levels from an administered dose, assuming one-compartment model. Acute kidney injury was also evaluated in our patients during vancomycin therapy.
Results: Mean (±SD) apparent volume of distribution (L/kg) and clearance (mL/min) were 0.6 (± 0.33) and 109.7 (± 57.5) respectively. With mean (±SD) total daily dose of vancomycin 31.9 (±10.5) mg/kg/day that was administered, more than 90 % of measured vancomycin trough concentrations were outside the range of 15-20 mg/L and 54.3% of patients had trough concentrations below 10 mg/L. Of 46 patients, 21 patients (45.7%) developed acute kidney injury (AKI) during vancomycin therapy; among them 19 patients were receiving nephrotoxic drug(s) concomitantly.
Conclusion: Current vancomycin dosage regimen could not lead to recommended therapeutic serum concentrations in our patients. Large variation in vancomycin pharmacokinetic parameters observed among patients of this study along with difference of vancomycin pharmacokinetics in our study and other similar studies further explain the need for therapeutic drug monitoring and individualization of vancomycin dosing.
|
topic |
Hematopoietic stem cell transplantation Neutropenic fever Pharmacokinetic parameters Vancomycin |
url |
https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/443 |
work_keys_str_mv |
AT maryamtaghizadehghehi vancomycinpharmacokineticparametersinpatientsundergoinghematopoieticstemcelltransplantationhsct AT saeedrezaee vancomycinpharmacokineticparametersinpatientsundergoinghematopoieticstemcelltransplantationhsct AT alirezahayatshahi vancomycinpharmacokineticparametersinpatientsundergoinghematopoieticstemcelltransplantationhsct AT moloukhadjibabaie vancomycinpharmacokineticparametersinpatientsundergoinghematopoieticstemcelltransplantationhsct AT kheirollahgholami vancomycinpharmacokineticparametersinpatientsundergoinghematopoieticstemcelltransplantationhsct AT mohammadrezajavadi vancomycinpharmacokineticparametersinpatientsundergoinghematopoieticstemcelltransplantationhsct AT seyedhamidkhoee vancomycinpharmacokineticparametersinpatientsundergoinghematopoieticstemcelltransplantationhsct AT maniaradfar vancomycinpharmacokineticparametersinpatientsundergoinghematopoieticstemcelltransplantationhsct AT mohsenesfandbod vancomycinpharmacokineticparametersinpatientsundergoinghematopoieticstemcelltransplantationhsct AT ardeshirghavamzadeh vancomycinpharmacokineticparametersinpatientsundergoinghematopoieticstemcelltransplantationhsct |
_version_ |
1724443782233980928 |