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Clinical applicability of urinary creatinine clearance for determining the initial dose of vancomycin in critically ill patients

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Please use this identifier to cite or link to this item:http://hdl.handle.net/2115/88121

Title: Clinical applicability of urinary creatinine clearance for determining the initial dose of vancomycin in critically ill patients
Authors: Mikami, Ryusei Browse this author
Imai, Shungo Browse this author →KAKEN DB
Hayakawa, Mineji Browse this author →KAKEN DB
Sugawara, Mitsuru Browse this author
Takekuma, Yoh Browse this author →KAKEN DB
Keywords: Therapeutic drug monitoring
Vancomycin
Critically ill patients
Augmented renal clearance
Issue Date: 1-Feb-2022
Publisher: Elsevier
Journal Title: Journal of infection and chemotherapy
Volume: 28
Issue: 2
Start Page: 199
End Page: 205
Publisher DOI: 10.1016/j.jiac.2021.10.008
Abstract: Introduction: The purpose of this study was to evaluate the clinical applicability of urinary creatinine clearance (CrCl) for determining the initial dose of vancomycin (VCM) in critically ill patients and to assess VCM trough plasma concentration/maintenance daily dose (C/D) ratio in patients with augmented renal clearance (ARC). Methods: As the primary outcome measure, correlations between estimated renal function and the VCM C/D ratio were compared using the following formulas: CrCl, Cockcroft-Gault equation (eCrClC-G) and KineticGFR equation (KeGFR). Patients were divided into those with or without changes in renal function. The patients were further classified based on the presence or absence of ARC. The secondary outcome was the comparison of VCM C/D ratio between ARC and Non-ARC patients. Results: A total of 65 patients were enrolled for analysis. In all groups, CrCl tended to correlate better with the VCM C/D ratio than eCrClC-G and KeGFR. A significantly lower VCM C/D ratio was observed in patients with persistent ARC than in the Non-ARC group (0.24 versus 0.52 kg/L). Conclusions: The clinical applicability of CrCl for the initial dosing design of VCM in critically ill patients was shown. Furthermore, the results indicated that patients with persistent ARC required a higher VCM dose than Non-ARC patients. Although our findings are limited, they have a value for further verification.
Rights: © 2021. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
https://creativecommons.org/licenses/by-nc-nd/4.0/
Type: article (author version)
URI: http://hdl.handle.net/2115/88121
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 武隈 洋

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