Pharmacokinetics of vancomycin in anuria.
After a single 1-g intravenous dose of vancomycin, the mean peak concentration in the serum of 29 anephric patients was 48.3 micrograms/ml. An initial rapid decline to 15 micrograms/ml within 3-5 hr was followed by slow elimination, with 3.5 micrograms/ml present after 18 days. Intermittent dialysis had no appreciable effect on drug levels in serum. The biphasic decline in serum concentrations of vancomycin indicates at least two-compartment pharmacokinetics in both anephric and normal patients. In anephric patients the elimination half-life was 7.5 days and the elimination rate constant was 0.32; these values were 8 hr and 10.25, respectively, in normal patients. On the basis of these results, the vancomycin regimen recommended for anephric patients is an initial 1-g intravenous dose followed by 500 mg every eight days. With these dosages peak concentrations are 49 micrograms/ml (well below reported toxic levels) and trough concentrations are 7 micrograms/ml (well above the minimal inhibitory concentrations for susceptible pathogens causing shunt infections).
D000293:Adolescent; D000328:Adult; D000368:Aged; D001002:Anuria / Q000097:blood / Q000378:metabolism*; D002648:Child; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D014640:Vancomycin / Q000008:administration & dosage / Q000097:blood / Q000378:metabolism*
D014640:Vancomycin