Therapeutic drug monitoring of vancomycin concentrations for the management of bone and joint infections: an urgent need
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- dc.contributor.author Rio-No, Laura
- dc.contributor.author Sorli Redó, M. Luisa
- dc.contributor.author Arderiu-Formentí, Alba
- dc.contributor.author Antonio, Marta de
- dc.contributor.author Martorell, Lucas
- dc.contributor.author Subirana, Isaac
- dc.contributor.author Puig, Lluís
- dc.contributor.author Alier Fabrego, Albert
- dc.contributor.author Gómez Junyent, Joan
- dc.contributor.author Pérez-Prieto, Daniel
- dc.contributor.author Luque, Sonia
- dc.date.accessioned 2023-06-20T10:30:01Z
- dc.date.available 2023-06-20T10:30:01Z
- dc.date.issued 2023
- dc.description.abstract Vancomycin is used for the treatment of bone and joint infections (BJI), but scarce information is available about its pharmacokinetic/pharmacodynamic (PK/PD) characteristics. We aimed to identify the risk factors associated with the non-achievement of an optimal PK/PD target in the first therapeutic drug monitoring (TDM). Methods: A retrospective study was conducted in a tertiary hospital from January 2020 to January 2022. Patients with BJI and TDM of vancomycin on day 2 of treatment were included. Initial vancomycin fixed doses (1 g every 8 h or 12 h) was decided by the responsible doctors. According to TDM results, dosage adjustments were performed. An AUC24h/MIC < 400 mg × h/L, between 400 and 600 mg × h/L and >600 mg × h/L, were defined as suboptimal, optimal and supratherapeutic, respectively. Patients were grouped into these three categories. Demographic, clinical and PK characteristics were compared between groups. Nephrotoxicity at the end of treatment was assessed. Results: A total of 94 patients were included: 22 (23.4%), 42 (44.7%) and 30 (31.9%) presented an infratherapeutic, optimal and supratherapeutic PK/PD targets, respectively. A younger age and initial vancomycin dose <40 mg/kg/day were predictive factors for achieving a suboptimal PK/PD target, while older age, higher serum-creatinine and dose >40 mg/kg/day were associated with overexposure. The nephrotoxicity rate was 22.7%. More than 50% of patients did not achieve an optimal PK/PD. Considering age, baseline serum-creatinine and body weight, TDM is required to readily achieve an optimal and safe exposure.
- dc.format.mimetype application/pdf
- dc.identifier.citation Rio-No L, Sorli L, Arderiu-Formenti A, De Antonio M, Martorell L, Subirana I, et al. Therapeutic drug monitoring of vancomycin concentrations for the management of bone and joint infections: an urgent need. TropicalMed. 2023 Feb;8(2):113. DOI: 10.3390/tropicalmed8020113
- dc.identifier.doi http://dx.doi.org/10.3390/tropicalmed8020113
- dc.identifier.issn 2414-6366
- dc.identifier.uri http://hdl.handle.net/10230/57275
- dc.language.iso eng
- dc.publisher MDPI
- dc.relation.ispartof Tropical Medicine and Infectious Disease. 2023 Feb;8(2):113
- dc.rights © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
- dc.rights.accessRights info:eu-repo/semantics/openAccess
- dc.rights.uri http://creativecommons.org/licenses/by/4.0/
- dc.subject.keyword Bone and joint infections
- dc.subject.keyword Vancomycin
- dc.subject.keyword Therapeutic drug monitoring
- dc.subject.keyword Pharmacokinetics
- dc.subject.keyword Nephrotoxicity
- dc.subject.keyword Dosage regimens
- dc.title Therapeutic drug monitoring of vancomycin concentrations for the management of bone and joint infections: an urgent need
- dc.type info:eu-repo/semantics/article
- dc.type.version info:eu-repo/semantics/publishedVersion