教員業績データベース |
|
論文種別 | 原著 |
言語種別 | 英語 |
査読の有無 | 査読なし |
表題 | Preferable timing of therapeutic drug monitoring in patients with impaired renal function treated with once-daily administration of vancomycin. |
掲載誌名 | 正式名:Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 略 称:J Infect Chemother ISSNコード:1437-7780(Electronic)1341-321X(Linking) |
巻・号・頁 | 19(4),pp.709-16 |
著者・共著者 | Takahashi Yoshiko, Takesue Yoshio, Takubo Shingo, Ishihara Mika, Nakajima Kazuhiko, Tsuchida Toshie, Ikeuchi Hiroki, Uchino Motoi |
発行年月 | 2013/08 |
概要 | The aim of this study was to investigate the timing of therapeutic drug monitoring (TDM) in patients with impaired renal function treated with once-daily administration of vancomycin (VCM). Once-daily administration was selected for patients whose creatinine clearance (Ccr) was<80 ml/min. TDM was conducted on day 3 or on day 4. Adult patients whose VCM dosage was not altered according to initial C min and for whom subsequent follow-up TDM was performed within 1 week were entered into the study. Patients whose renal function deteriorated at follow-up TDM were excluded. One hundred sixty-five patients were eligible for analysis. Among patients with once-daily dosing, relative increases of C min at follow-up TDM compared with initial TDM were 34.5 ± 39.2 % in TDM on day 3 and 16.6 ± 20.6 % in TDM on day 4 (P = 0.016). In contrast, there was no significant difference in the relative increase of C min between TDM on days 3 and 4 (26.1 ± 39.6 vs. 18.4 ± 25.6 %, P = 0.551) in the twice-daily regimen. On multivariate analysis, TDM on day 3 alone (odds ratio, 4.93; 95 % confidence interval, 1.71-14.2) was selected as an independent risk factor associated with a relative increase of C min by>30 % in the once-daily regimen. Steady-state VCM serum concentration was not achieved on day 3 in the once-daily regimen in patients with impaired renal function, and TDM on day 3 caused underestimation of C min. |
DOI | 10.1007/s10156-013-0551-7 |
文献番号 | 23345049 |