title: Application of vancomycin in patients with varying renal function, especially those with augmented renal clearance.
abstract: BACKGROUND
  Augmented renal clearance (ARC) refers to enhanced renal elimination of circulating solute, and has attracted wide attention in recent years.
  
  
  OBJECTIVE
  This study evaluates the effects of ARC on serum vancomycin concentration in patients administered vancomycin.
  
  
  METHODS
  This was a retrospective study in patients receiving vancomycin treatment at a dose of 1000 mg in every 12 h and undergoing serum monitoring admitted over a 2-year period (May 2013 to May 2015), in order to estimate the influence of ARC on serum vancomycin concentration. In this study, statistical comparisons were made on the results from patients grouped according to creatinine clearance (CLcr).
  
  
  RESULTS
  One hundred forty-eight patients were enrolled in our study. The results showed that ARC patients were significantly younger, with a significantly lower Scrand higher GFR. The CLcrand steady-state trough concentrations of serum vancomycin exhibited a logarithmic correlation (Rs = -0.699, R2=0.488, p < 0.01) in the patients included in our study. The trough vancomycin concentrations of 62.9% patients in high CLcrgroup were under 10 μg/mL.
  
  
  CONCLUSIONS
  Since ARC was significantly associated with subtherapeutic serum vancomycin concentration, it was necessary to devise adjusted dosage regimens for these patients based on their CLcr.
authors.affiliation: a Department of Pharmacy , the First Affiliated Hospital of China Medical University , Shenyang , China.|b Department of the First Clinical Pharmacy , China Medical University , Shenyang , China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Chu
authors.affiliation: a Department of Pharmacy , the First Affiliated Hospital of China Medical University , Shenyang , China.|b Department of the First Clinical Pharmacy , China Medical University , Shenyang , China.
authors.forename: Yifan
authors.initials: Y
authors.lastname: Luo
authors.affiliation: a Department of Pharmacy , the First Affiliated Hospital of China Medical University , Shenyang , China.|b Department of the First Clinical Pharmacy , China Medical University , Shenyang , China.
authors.forename: Lianyue
authors.initials: L
authors.lastname: Qu
authors.affiliation: a Department of Pharmacy , the First Affiliated Hospital of China Medical University , Shenyang , China.|b Department of the First Clinical Pharmacy , China Medical University , Shenyang , China.
authors.forename: Chunyang
authors.initials: C
authors.lastname: Zhao
authors.affiliation: a Department of Pharmacy , the First Affiliated Hospital of China Medical University , Shenyang , China.
authors.forename: Mingyan
authors.initials: M
authors.lastname: Jiang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000097:blood* / Q000494:pharmacology / Q000627:therapeutic use; D002648:Child; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000187:drug effects* / Q000378:metabolism; D007674:Kidney Diseases / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D008657:Metabolic Clearance Rate / Q000187:drug effects* / Q000502:physiology; D008875:Middle Aged; D012189:Retrospective Studies; D014640:Vancomycin / Q000097:blood* / Q000494:pharmacology / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin
keywords: ARC; creatinine clearance; dosage regimen; steady-state trough concentration; therapeutic drug monitoring