[Analysis of factors in selecting anti-methicillin-resistant Staphylococcus aureus drugs by doctors].
Three types of medication, Arbekacin, Vancomycin, and Teicoplanin, are used primarily to treat MRSA infections. These medications differ in their respective anti-bacterial actions, antibacterial spectrums, and pharmacokinetics. Proper use and dosage is required, and is based on patient background and the conditions of infection, among other factors. This study was conducted for a period of over one year at St. Marianna University School of Medicine, Yokohama City Seibu Hospital. It was designed to compare the conditions as they related to why doctors ordered a certain drug, the background, and their clinical examination values. The tendency to avoid selection of Arbekacin Sulfate (ABK) for patients who had kidney dysfunction was recognized, although there were a few exceptions made. Other than that, there were not any standard criteria set in selecting which medication to prescribe. Therefore, it is necessary to examine the appropriateness of the selection since ordering anti-MRSA medication seemed to depend on each doctor's own experience. Serum concentration was measured in order to avoid any side effects. Moreover, cases of young people, normal renal function and malignant tumor patients were recognized in which serum concentration of the anti-MRSA medications was not within the therapeutic range of therapeutic drug monitoring (TDM). This was to show that there is a possibility the medications involved were not sufficiently effective. Therefore, in the future it will be necessary to ensure that proper dosing instructions are followed.
Hayashi
Hiroyuki
H
Department of Pharmacy, Yokohama City Seibu Hospital, St. Marianna University, Yasashi-cho, Asahi-ku, Yokohama, Japan. hayashi8@marianna.ac.jp
Matsuzaki
Takashi
T
Saito
Akio
A
Aoyama
Takahiko
T
Matsumoto
Yoshiaki
Y
D000328:Adult; D000368:Aged; D000617:Aminoglycosides / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D003982:Dibekacin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000493:pharmacokinetics; D016903:Drug Monitoring; D006801:Humans; D016106:Methicillin Resistance; D008875:Middle Aged; D013203:Staphylococcal Infections / Q000188:drug therapy*; D013211:Staphylococcus aureus / Q000187:drug effects*; D017334:Teicoplanin / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D014640:Vancomycin / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D003982:Dibekacin; D017334:Teicoplanin; D014640:Vancomycin; C031986:arbekacin