Andrius Klimašauskas, Aistė Grinkutė, Aistė Visockytė, Gintautas Kėkštas, Jūratė Šipylaitė
Abstract
Objective. To evaluate how often the therapeutic concentration of vancomycin are achieved for critically ill patients in intensive care units (ICU). Materials and methods. There was a retrospective study carried out in Vilnius University Hospital Santariskiu clinics. We evaluate the all vancomycin concentration measurements, done for patients in three intensive care units (ICU) of Santariškių clinics during 2013-2015. The measurements were divided into three groups according to the vancomycin concentration in blood plasma: 1st group (subtherapeutic vancomycin concentration), results lower than 15 mg/l, 2nd group (therapeutic vancomycin concentration) – results between 15-25 mg/l, 3rd group (exceeded vancomycin concentration) – more than 25 mg/l. Comparison between three years of analysis was done. Also the comparison between measurements in 3 ICU of Santariskiu clinics was done. Rezults. 3512 measurements of vancomycin concentration for 622 patients were conducted in a three-years period. The median of vancomycin concentration was almost the same in 3 years: in 2013 – 21.4 mg/l (min 0.0 max 77.5 mg/l), in 2014 – 20.45 mg/l (min 0.0 max 143.7 mg/l) , in 2015 – 21.8 mg/l (min 0.0 max 122.4 mg/l). The distribution by concentration of vancomycin in groups was without differences .1st group (subtherapeutic vancomycin concentration) –1116 (32%) of cases; 2nd group (therapeutic vancomycin concentration) – 1143 (32%) of cases; 3rd group (excedeed vancomycin concentration) – 1126 (35%) of cases. No essential differences between three years of analysis were found. In 240 (21%) of cases toxic concentrations were reached (> 30 mg/l). The bigest part of measurements with therapeutic concentration were determined in the 1 st ICU. Conclusions. In big part of patients therapeutic concentration of vancomycin was not reached. In more than one third of cases therapeutic concentration was exceeded. In case standartized protocol for vancomycin infusion is used, therapeutic concentrations are reached more often.
Keyword(s): vancomycin; dosage; toxicity; critically ill patients; therapeutic concentration.
DOI: 10.5200/sm-hs.2016.022
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