Journal Information
Vol. 14. Issue 2.
Pages 203-208 (March - April 2010)
Share
Share
Download PDF
More article options
Vol. 14. Issue 2.
Pages 203-208 (March - April 2010)
Brief communication
Open Access
Vancomycin: the need to suit serum concentrations in hemodialysis patients
Visits
2349
Lívia Luize Marengo1, Fernando de Sá Del Fiol2, Sara de Jesus Oliveira2, Celso Nakagawa3, Eduardo Leite Croco3, Silvio Barberato-Filho2, Marcela Pellegrini Peçanha4, Douglas Felix da Silva2, Maria Inês de Toledo2,5,
Corresponding author
mitoledo@yahoo.com

Correspondence to: Rua Silvério E. Oliveira, 160 – Jd. Saira Sorocaba – São Paulo – Brazil CEP: 18085-645 Phone: 55 15 3238 5266.
1 Pharmacy School of Universidade de Sorocaba PIBIC-CNPq
2 Researcher of the Reference Center on Information About Antibiotics (CRIA) of Universidade de Sorocaba
3 Conjunto Hospitalar de Sorocaba
4 Faculdade de Ciências Médicas e da Saúde - PUC São Paulo
5 Faculdade de Tecnologia de Sorocaba
This item has received

Under a Creative Commons license
Article information
Abstract

The vancomycin dose for hemodialysis (HD) patients should be adjusted by monitoring drug serum concentrations. However, this procedure is not available in most health services in Brazil, which usually adopts protocols based on published studies. The trials available are controversial, and several have not been conducted with current dialyzers. This study aimed at assessing the suitability of vancomycin serum concentrations in HD patients at a public hospital. Blood samples of HD patients were collected from November 2006 to May 2007, at time intervals of 48, 96, 120, or 168 hours after vancomycin administration. Drug measurement was performed with polarized light immunofluorescence. Approximately 86% of trough vancomycin serum concentrations were below the recommended value, indicating exposure to subtherapeutic doses and a higher risk for selecting resistant microorganisms.

Keywords:
vancomycin
chronic renal failure
hemodialysis
Full text is only aviable in PDF
References
[1.]
Klasco RK editor. Martindale: the extra pharmacopoeia. Base de dados na Internet. Greenwood Village: Thomson MICROMEDEX; 1974-2006. Disponível: http://www.periodicos.capes.gov.br. Acesso em 20 de maio de 2008.
[2.]
M. Ge, Z. Chen, H.R. Onishi, J. Kohler, L.L. Silver, et al.
Vancomycin derivatives that inhibit peptidoglycan biosynthesis without binding D-ala-D-ala.
Science, 284 (1999), pp. 507-510
[3.]
Marinho, DS Vancomicina, estudo de utilização com ênfase em suas reações adversas. 2005. 120 f. Dissertação (Mestrado) – Fundação Oswaldo Cruz, Rio de Janeiro, 2005.
[4.]
Bartlett JG Antibiotic selection for infections involving methicillin-resistant Staphylococcus aureus. 2004. Disponível em: http://www.medscape.com/viewprogram/3124. Acesso em 03 de dezembro 2007.
[5.]
J.R. Lentino, D.J. Leehey.
Infecções.
Manual de diálise, 3. ed.,
[6.]
C.R.R. Marcondes, C.R. Biojone, J.M. Cherri, P. Takachi, E. Carlos.
Complicações precoces e tardias em acesso venoso central: análise de 66 implantes.
Acta Cirúrgica Brasileira, 15 (2007), pp. 73-75
[7.]
N.A. Mason, B.L. Neudeck, L.S. Welage, J.A. Patel, R.D. Swartz.
Comparison of 3 vancomycin dosage regimens during hemodialysis with cellulose triacetate dialyzers: post-dialysis versus intradialytic administration.
Clinical Nephrology, 60 (2003), pp. 96-104
[8.]
L.A.M. Silva, H.M. Pansard, D.B. Rosa, S.R. Botton, N.F. Mezzomo, et al.
Níveis sanguíneos de vancomicina e adequação de seu uso em pacientes com insuficiência renal em tratamento dialítico.
Jornal Brasileiro de Nefrologia, 20 (1998), pp. 411-418
[9.]
W. Tavares.
Glicopeptídeos e Lipopeptídeos.
Antibióticos e quimioterápicos para o clínico, Atheneu, (2007),
[10.]
V. Launay-Vacher, H. Izzedine, L. Mercadal, G. Deray.
Clinical review: use of vancomycin in haemodialysis patients.
Critical Care, 6 (2002), pp. 313-316
[11.]
L.L. Livornese, D. Slavin, B. Gilbert, P. Robbins, J. Santoro.
Use of antimicrobial agents in renal failure.
Infectious Disease Clinics of North America, 18 (2004), pp. 551-579
[12.]
E. Bingen, P. Mariani-Kurkdjian, B. Nebbad.
Optimal vancomycin serum level in Staphylococcus aureus infections?.
Medecine et Maladies Infectieuses, 36 (2006), pp. 439-442
[13.]
G.L. Mandell, J.E. Bennett, R. Dolin.
Mandell, Douglas and Bennett's: principles and pratice of infectious diseases.
6 ed., Elsevier, (2005),
[14.]
M.E. Stryjewski, L.A. Szczech, D.K. Benjamin, J.K. Inrig, Z.A. Kanafani, et al.
Use of vancomycin or first-generation cephalosporins for the treatment of hemodialisys-dependent patients with methicillin-susceptible Staphylococcus aureus bacteremia.
Clinical Infectious Diseases, 20 (2007), pp. 190-196
[15.]
H.E. Nielsen, H.E. Hansen, B. Korsager, P.E. Skov.
Renal excretion of vancomycin in kidney disease.
Acta Medica Scandinavica, 197 (1975), pp. 261-264
[16.]
H. Masur, P. Francioli, M. Ruddy, H.W. Murray.
Vancomycin serum levels and toxicity in chronic hemodialysis patients with Staphylococcus aureus bacteremia.
Clinical Nephrology, 2 (1993), pp. 85-88
[17.]
G. Gonzalez-Martin, V. Acuna, C. Perez, J. Labarca, A. Guevara, R. Tagle.
Pharmacokinetics of vancomycin in patients with severely impaired renal function.
International Journal of Clinical Pharmacology and Therapeutics, 34 (1996), pp. 71-75
[18.]
J. Zoer, A.M. Schrander-Van Der Meer, W.T. Van Dorp.
Dosage recommendations of vancomycin during haemodialysis with highly permeable membranes.
Pharmacy World & Science, 19 (1997), pp. 191-196
[19.]
E.F. Foote, W.B. Dreitlein, C.A. Steward, T. Kapoian, J.A. Walker, R.A. Sherman.
Pharmacokinetics of vancomycin when administered high flux hemodialysis.
Clinical Nephrology, 50 (1998), pp. 51-55
[20.]
A. Lucksiri, M.K. Scott, B.A. Mueller, R.J. Hamburger, K.M. Sowinski.
CAHP-210 dialyzer influence on intra-dialytic vancomycin removal.
Nephrology Dialysis Transplantation, 17 (2002), pp. 1649-1654
[21.]
L. Goldman, D. Ausiello.
Cecil: tratado de medicina interna.
22. ed., Elsevier, (2005),
[22.]
R.C. Bernardes, A.O.C. Jorge, M.V.P. Leão.
Sensibilidade à oxacilina, vancomicina e teicoplanina de Staphylococcus coagulase-positivo isolados de pacientes hospitalizados de São José dos Campos.
Revista Biociências, 10 (2004), pp. 73-78
[23.]
W.E. Rose, M.J. Rybak, B.T. Tsuji, G.W. Kaatz, G. Sakoulas.
Correlation of vancomycin and daptomycin susceptibility in Staphylococcus aureus infererence to accessory gene regulator (agr) polymorphism and function.
Journal of Antimicrobial Chemotherapy, 59 (2007), pp. 1190-1193
[24.]
G. Sakoulas, S.G. Howard, R.A. Cohen, L. Venkataraman, R.C. Moellering, G.M. Eliopoulos.
Effects of prolonged vancomycin administration on methicillin-resistant Staphylococcus aureus (MRSA) in a patient with recurrent bacteraemia.
Journal of Antimicrobial Chemotherapy, 57 (2006), pp. 699-704
[25.]
A.P. Johnson, N. Woodford.
Glycopeptide-resistant Staphylococcus aureus.
Journal of Antimicrobial Chemotherapy, 50 (2002), pp. 621-623
[26.]
Center for Disease Control and Prevention. Laboratory capacity to detect antimicrobial resistance. 1998; 48:1167-71.
[27.]
R.G. Finch, G.M. Eliopoulos.
Safety and efficacy glicopeptide antibiotics.
Journal of Antimicrobial Chemotherapy, 55 (2005), pp. ii5-ii13
[28.]
C.R. Santos, R. Feferbaum, L.S.A. Paula, M.A. Bertoline, C.E.K. Omosako, S.R.C. Santos.
Micrométodo para quantificação da vancomicina em plasma através da cromatografia líquida de alta eficiência: monitorização plasmática de vancomicina na sustentação farmacológica de neonatos com sepse.
Revista Brasileira de Ciências Farmacêuticas, 37 (2001), pp. 87-93
Copyright © 2010. Elsevier Editora Ltda.. All rights reserved
The Brazilian Journal of Infectious Diseases
Article options
Tools