Abstract
Our aims were to elucidate the factors that affected vancomycin (VCM) serum trough levels and to find the optimal initial dose based on creatinine clearance (CrCl) and body weight (BW) to minimize inadequate trough levels in a retrospective observational study among Japanese adults. One hundred and six inpatients, in whom VCM trough levels were measured after completing the third dosing, were consecutively recruited into our study in a tertiary hospital. We considered the frequency of <30% as low. In the generalized linear model, initial VCM total daily dose, CrCl, and BW were independent risk factors of VCM trough levels. In patients with CrCl ≥30 and <50 mL/min, 1 g/day yielded low frequencies of a trough level of ≥20 mcg/mL, regardless of BW. In patients with CrCl ≥50 mL/min, 2 g/day yielded low frequencies of a trough level of <10 mcg/mL in patients weighing <55 kg, but not in patients weighing ≥55 kg. Optimal VCM initial total daily dose may be 1 g/day in patients with CrCl ≥30 and <50 mL/min regardless of BW and 2 g/day in patients weighing <55 kg with CrCl ≥50 mL/min among Japanese adults.
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Acknowledgments
The authors are grateful for the assistance of Toshiyuki Ojima, Takahiro Mochizuki, Norio Ohmagari, Taro Takeshima, Hitoshi Ando, Koichi Sakamoto, Harumi Yano, Masaki Toshima, Toyomi Kamesaki, and the Clinical Research Support Team (CRST) of Jichi Medical University. Some information about vancomycin was provided by Shionogi Co., Ltd., Osaka, Japan. The authors have declared no conflicts of interest.
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Maki, N., Ohkuchi, A., Tashiro, Y. et al. Initial dose of vancomycin based on body weight and creatinine clearance to minimize inadequate trough levels in Japanese adults. Eur J Clin Microbiol Infect Dis 31, 2537–2543 (2012). https://doi.org/10.1007/s10096-012-1593-y
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DOI: https://doi.org/10.1007/s10096-012-1593-y