Vancomycin: the need to suit serum concentrations in hemodialysis patients.
The vancomycin dose for hemodialysis (HD) patients should be adjusted by monitoring drug serum concentrations. However, this procedure is not available in most health services in Brazil, which usually adopts protocols based on published studies. The trials available are controversial, and several have not been conducted with current dialyzers. This study aimed at assessing the suitability of vancomycin serum concentrations in HD patients at a public hospital. Blood samples of HD patients were collected from November 2006 to May 2007, at time intervals of 48, 96, 120, or 168 hours after vancomycin administration. Drug measurement was performed with polarized light immunofluorescence. Approximately 86% of trough vancomycin serum concentrations were below the recommended value, indicating exposure to subtherapeutic doses and a higher risk for selecting resistant microorganisms.
Marengo
Lívia Luize
LL
Pharmacy School, Universidade de Sorocaba, Rua Silvério E. Oliveira 160, Jd. Saira Sorocaba, São Paulo, Brazil. mitoledo@yahoo.com
Del Fiol
Fernando de Sá
Fde S
Oliveira
Sara de Jesus
Sde J
Nakagawa
Celso
C
Croco
Eduardo Leite
EL
Barberato-Filho
Silvio
S
Peçanha
Marcela Pellegrini
MP
Silva
Douglas Felix da
DF
Toledo
Maria Inês de
MI
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000097:blood*; D016903:Drug Monitoring; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D013997:Time Factors; D014640:Vancomycin / Q000008:administration & dosage / Q000097:blood*
D000900:Anti-Bacterial Agents; D014640:Vancomycin