The Most Appropriate Parameter Correlates With Clinical Effectiveness of Vancomycin: Trough Drug Concentration or Area Under Curve (AUC)/Minimum Inhibitory Concentration (MIC)?
Last updated on April 2022Recruitment
- Recruitment Status
- Completed
- Estimated Enrollment
- 1500
Inclusion Criteria
- Inpatients of National Taiwan University Hospital
- Undergoing therapeutic drug monitoring (had serum vancomycin concentration level)
- Positive methicillin-resistant Staphylococcus aureus blood culture
- ...
- Inpatients of National Taiwan University Hospital
- Undergoing therapeutic drug monitoring (had serum vancomycin concentration level)
- Positive methicillin-resistant Staphylococcus aureus blood culture
- Age above or equal to 20 years old
- Receiving vancomycin therapy for definitive use
Exclusion Criteria
- Vancomycin treatment shorter than 72 hours
- Receiving renal replacement therapy
- Without renal function data (serum creatinine level, creatinine clearance)
- ...
- Vancomycin treatment shorter than 72 hours
- Receiving renal replacement therapy
- Without renal function data (serum creatinine level, creatinine clearance)
- With abnormal and undefined serum concentration
- Without details of vancomycin dose and frequency
- Without infection-related clinical outcomes (lab data such as white blood cell count , seg, C reactive protein , body temperature records)
- Therapeutic drug monitoring before reaching steady state
- Age below 20 years old
Summary
- Conditions
- Methicillin-resistant Staphylococcus Aureus Septicemia
- Type
- Observational
- Design
- Observational Model: Cohort
- Time Perspective: Retrospective
Participation Requirements
- Age
- Between 20 years and 125 years
- Gender
- Both males and females
Description
Several studies have shown AUC/MIC to be the better pharmacokinetic-pharmacodynamic parameter for clinical effectiveness of vancomycin. However, the 2009 consensus guideline for vancomycin therapeutic monitoring continued to recommend trough serum concentration monitoring in the clinical setting. In...
Several studies have shown AUC/MIC to be the better pharmacokinetic-pharmacodynamic parameter for clinical effectiveness of vancomycin. However, the 2009 consensus guideline for vancomycin therapeutic monitoring continued to recommend trough serum concentration monitoring in the clinical setting. In 2011, Patel et al showed that highly difference between AUC(72-96h) and Cmin(96h). Different dosing and creatinine clearance may reach the same trough drug level with different AUC. The investigators wonder whether trough drug level can serve as a substitute marker for AUC and as a parameter for vancomycin therapeutic monitoring. In this study, the investigators will calculate AUC/MIC of vancomycin with published formula, analyze its correlation with patient's clinical outcome and compare that with trough drug level.
Inclusion Criteria
- Inpatients of National Taiwan University Hospital
- Undergoing therapeutic drug monitoring (had serum vancomycin concentration level)
- Positive methicillin-resistant Staphylococcus aureus blood culture
- ...
- Inpatients of National Taiwan University Hospital
- Undergoing therapeutic drug monitoring (had serum vancomycin concentration level)
- Positive methicillin-resistant Staphylococcus aureus blood culture
- Age above or equal to 20 years old
- Receiving vancomycin therapy for definitive use
Exclusion Criteria
- Vancomycin treatment shorter than 72 hours
- Receiving renal replacement therapy
- Without renal function data (serum creatinine level, creatinine clearance)
- ...
- Vancomycin treatment shorter than 72 hours
- Receiving renal replacement therapy
- Without renal function data (serum creatinine level, creatinine clearance)
- With abnormal and undefined serum concentration
- Without details of vancomycin dose and frequency
- Without infection-related clinical outcomes (lab data such as white blood cell count , seg, C reactive protein , body temperature records)
- Therapeutic drug monitoring before reaching steady state
- Age below 20 years old
Tracking Information
- NCT #
- NCT01995760
- Collaborators
- Not Provided
- Investigators
- Principal Investigator: Li-Jiuan Shen National Taiwan University Hospital
- Li-Jiuan Shen National Taiwan University Hospital