Do low vancomycine serum levels predict failures of vancomycine therapy in neutropenic cancer patients?
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.).
Netriová
J
J
Department of Pharmacology, National Cancer Institute, Bratislava, Slovakia.
Hal'ko
J
J
Studená-Mrázová
M
M
Kukucková
E
E
Stopková
K
K
Kral'ovicová
K
K
Demitrovicová
A
A
Grausová
S
S
Krupová
I
I
Trupl
J
J
Krcméry
V
V
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
D000900:Anti-Bacterial Agents; D014640:Vancomycin