title: Do low vancomycine serum levels predict failures of vancomycine therapy in neutropenic cancer patients?
abstract: Vancomycine serum levels were measured in 198 cancer patients with documented grampositive bacteremia and twenty two failed. Failures were analyzed for risk factors of therapy failure. Only 8 of 22 showed low serum peak or through vancomycin levels. One patient was treated less than 7 days, 9 had persisting and 4 catheter associated bacteremia. Bacteremias due to VAN resistant strains were excluded. In 14 out of 22 patients, multiple or one risk factor could be determined, but in 8 patients, no risk factor was found. Hence the, case control study was conducted to compare the group of failures in 22 patients with a group of patients with underlying disease and neutropenia treated successfully within the same period and same antibiotic policy at the same cancer center, by VAN for gram-positive bacteremia. Persisting, catheter associated and enterococcal bacteremias were the only statistical significant risk factors predicting a therapy failure in cancer patients. Neither Vancomycine serum peak nor through levels predicted the outcome: failure or cure of gram-positive bacteremia in cancer patients. (Tab. 1, Ref. 5.).
authors.affiliation: Department of Pharmacology, National Cancer Institute, Bratislava, Slovakia.
authors.forename: J
authors.initials: J
authors.lastname: Netriová
authors.forename: J
authors.initials: J
authors.lastname: Hal'ko
authors.forename: M
authors.initials: M
authors.lastname: Studená-Mrázová
authors.forename: E
authors.initials: E
authors.lastname: Kukucková
authors.forename: K
authors.initials: K
authors.lastname: Stopková
authors.forename: K
authors.initials: K
authors.lastname: Kral'ovicová
authors.forename: A
authors.initials: A
authors.lastname: Demitrovicová
authors.forename: S
authors.initials: S
authors.lastname: Grausová
authors.forename: I
authors.initials: I
authors.lastname: Krupová
authors.forename: J
authors.initials: J
authors.lastname: Trupl
authors.forename: V
authors.initials: V
authors.lastname: Krcméry
mesh_terms: D000900:Anti-Bacterial Agents / Q000097:blood* / Q000627:therapeutic use; D016470:Bacteremia / Q000150:complications / Q000188:drug therapy*; D016908:Gram-Positive Bacterial Infections / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D009369:Neoplasms / Q000150:complications*; D009503:Neutropenia / Q000150:complications*; D012189:Retrospective Studies; D017211:Treatment Failure; D014640:Vancomycin / Q000097:blood* / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin