Low Correlation Between Vancomycin Area Under the Curve Over 24 Hours to the MIC (AUC/MIC ratio) and the Trough Concentration at Steady State in Methicillin-Resistant Staphylococcus Aureus Pneumonia

@article{ART002650159},
author={ 손유민/SOHN YOU MIN and 박효정/Hyo Jung Park and 정지은/Chung Jee Eun and 허경민/Kyungmin Huh and 전경만/JEON ， KYEONG MAN and 이용석/Yong Seok Lee and 민명숙/MIN MYUNG SOOK },
title={Low Correlation Between Vancomycin Area Under the Curve Over 24 Hours to the MIC (AUC/MIC ratio) and the Trough Concentration at Steady State in Methicillin-Resistant Staphylococcus Aureus Pneumonia},
journal={병원약사회지},
issn={1226-640X},
year={2020},
volume={37},
number={4},
pages={408-416},
doi={10.32429/jkshp.2020.37.4.001},
url={http://dx.doi.org/10.32429/jkshp.2020.37.4.001}

TY - JOUR
AU - 손유민/SOHN YOU MIN
AU - 박효정/Hyo Jung Park
AU - 정지은/Chung Jee Eun
AU - 허경민/Kyungmin Huh
AU - 전경만/JEON ， KYEONG MAN
AU - 이용석/Yong Seok Lee
AU - 민명숙/MIN MYUNG SOOK
TI - Low Correlation Between Vancomycin Area Under the Curve Over 24 Hours to the MIC (AUC/MIC ratio) and the Trough Concentration at Steady State in Methicillin-Resistant Staphylococcus Aureus Pneumonia
T2 - 병원약사회지
PY - 2020
VL - 37
IS - 4
PB - 한국병원약사회
SP - 408-416
SN - 1226-640X
AB - Background : Vancomycin is a mainstay of treatment of serious methicillin-resistant Staphylococcus aureus (MRSA) infections. The recently published guideline on vancomycin monitoring recommends that a vancomycin loading dose can be considered and an individualized target AUC/MIC ratio of 400-600 and should be advocated to achieve clinical efficacy while improving safety in patients with the suspected or definitive MRSA infections. Methods : To evaluate the correlation between the vancomycin trough concentration and the area under the curve over 24 hours to the MIC (AUC/MIC) ratio according to the guideline recently published. A retrospective cohort study was conducted on adult patients treated for MRSA proven pneumonia with the vancomycin. We enrolled patients administered with the vancomycin loading dose before the maintenance dose and the monitored vancomycin trough concentrations at the steady state in medical intensive care units April 2017-March 2020. We calculated the vancomycin AUC/MIC ratio based on the trough concentration measured for each patient using the Bayesian software. The difference between the microbiological cure, all-cause mortality, and nephrotoxicity for each group was studied. Results : There was low correlation between the vancomycin AUC/MIC and trough concentration in MRSA pneumonia. A total of 35 patients were included. Thirty-one patients (88.6%) were above the AUC/MIC ratio 400, while 19 patients (54.3%) were in the trough range above 15 mcg/ ml. Although there was a weak correlation between the vancomycin trough concentration and the AUC/MIC ratio (r=0.427, p=0.010), the vancomycin through concentrations at the steady state within the therapeutic ranges did not mean the vancomycin AUC/MIC ratio within the therapeutic ranges (p=0.580). No significant difference was observed in the microbiological cure, all-cause mortality, and incidence of acute kidney injury in each group. Conclusion : The trough level-guided monitoring of the vancomycin should be replaced by the AUC/MIC ratio-guided monitoring in the clinical practice in Korea.
KW - Vancomycin, Trough concentration, AUC/MIC ratio, MRSA pneumonia
DO - 10.32429/jkshp.2020.37.4.001
UR - http://dx.doi.org/10.32429/jkshp.2020.37.4.001
ER -

손유민/SOHN YOU MIN , 박효정/Hyo Jung Park , 정지은/Chung Jee Eun , 허경민/Kyungmin Huh , 전경만/JEON ， KYEONG MAN , 이용석/Yong Seok Lee and 민명숙/MIN MYUNG SOOK (2020). Low Correlation Between Vancomycin Area Under the Curve Over 24 Hours to the MIC (AUC/MIC ratio) and the Trough Concentration at Steady State in Methicillin-Resistant Staphylococcus Aureus Pneumonia. 병원약사회지, 37( 4), 408- 416.

손유민/SOHN YOU MIN , 박효정/Hyo Jung Park , 정지은/Chung Jee Eun , 허경민/Kyungmin Huh , 전경만/JEON ， KYEONG MAN , 이용석/Yong Seok Lee and 민명숙/MIN MYUNG SOOK . 2020, “Low Correlation Between Vancomycin Area Under the Curve Over 24 Hours to the MIC (AUC/MIC ratio) and the Trough Concentration at Steady State in Methicillin-Resistant Staphylococcus Aureus Pneumonia”, 병원약사회지, vol. 37, no. 4, pp. 408-416. Available from: doi:10.32429/jkshp.2020.37.4.001

손유민/SOHN YOU MIN 박효정/Hyo Jung Park et al. 정지은/Chung Jee Eun 허경민/Kyungmin Huh 전경만/JEON ， KYEONG MAN 이용석/Yong Seok Lee 민명숙/MIN MYUNG SOOK “Low Correlation Between Vancomycin Area Under the Curve Over 24 Hours to the MIC (AUC/MIC ratio) and the Trough Concentration at Steady State in Methicillin-Resistant Staphylococcus Aureus Pneumonia” 병원약사회지 37.4 pp. 408-416 (2020): 408.

손유민/SOHN YOU MIN , 박효정/Hyo Jung Park , 정지은/Chung Jee Eun , 허경민/Kyungmin Huh , 전경만/JEON ， KYEONG MAN , 이용석/Yong Seok Lee , 민명숙/MIN MYUNG SOOK . Low Correlation Between Vancomycin Area Under the Curve Over 24 Hours to the MIC (AUC/MIC ratio) and the Trough Concentration at Steady State in Methicillin-Resistant Staphylococcus Aureus Pneumonia 병원약사회지 [Internet]. 2020; 37( 4), : 408-416. Available from: doi:10.32429/jkshp.2020.37.4.001

손유민/SOHN YOU MIN , 박효정/Hyo Jung Park , 정지은/Chung Jee Eun , 허경민/Kyungmin Huh , 전경만/JEON ， KYEONG MAN , 이용석/Yong Seok Lee and 민명숙/MIN MYUNG SOOK . “Low Correlation Between Vancomycin Area Under the Curve Over 24 Hours to the MIC (AUC/MIC ratio) and the Trough Concentration at Steady State in Methicillin-Resistant Staphylococcus Aureus Pneumonia” 병원약사회지 37, no.4 (2020): 408-416. doi: 10.32429/jkshp.2020.37.4.001

홈 권호 목록 논문 목록 논문 상세

Low Correlation Between Vancomycin Area Under the Curve Over 24 Hours to the MIC (AUC/MIC ratio) and the Trough Concentration at Steady State in Methicillin-Resistant Staphylococcus Aureus Pneumonia
Low Correlation Between Vancomycin Area Under the Curve Over 24 Hours to the MIC (AUC/MIC ratio) and the Trough Concentration at Steady State in Methicillin-Resistant Staphylococcus Aureus Pneumonia

병원약사회지

약어 : JKSHP

2020, vol.37, no.4, pp.408 - 416

DOI : 10.32429/jkshp.2020.37.4.001

발행기관 : 한국병원약사회

연구분야 : 약학

손유민/SOHN YOU MIN¹ , 박효정/Hyo Jung Park² , 정지은/Chung Jee Eun³ , 허경민/Kyungmin Huh⁴ , 전경만/JEON ， KYEONG MAN⁵ , 이용석/Yong Seok Lee⁶ , 민명숙/MIN MYUNG SOOK⁷

¹삼성서울병원

²삼성서울병원 약제부

³한양대학교

⁴삼성서울병원

⁵삼성서울병원

⁶삼성서울병원

⁷삼성서울병원

인용한 논문 수 : - 서지 간략 보기

초록

Background : Vancomycin is a mainstay of treatment of serious methicillin-resistant Staphylococcus aureus (MRSA) infections. The recently published guideline on vancomycin monitoring recommends that a vancomycin loading dose can be considered and an individualized target AUC/MIC ratio of 400-600 and should be advocated to achieve clinical efficacy while improving safety in patients with the suspected or definitive MRSA infections. Methods : To evaluate the correlation between the vancomycin trough concentration and the area under the curve over 24 hours to the MIC (AUC/MIC) ratio according to the guideline recently published. A retrospective cohort study was conducted on adult patients treated for MRSA proven pneumonia with the vancomycin. We enrolled patients administered with the vancomycin loading dose before the maintenance dose and the monitored vancomycin trough concentrations at the steady state in medical intensive care units April 2017-March 2020. We calculated the vancomycin AUC/MIC ratio based on the trough concentration measured for each patient using the Bayesian software. The difference between the microbiological cure, all-cause mortality, and nephrotoxicity for each group was studied. Results : There was low correlation between the vancomycin AUC/MIC and trough concentration in MRSA pneumonia. A total of 35 patients were included. Thirty-one patients (88.6%) were above the AUC/MIC ratio 400, while 19 patients (54.3%) were in the trough range above 15 mcg/ ml. Although there was a weak correlation between the vancomycin trough concentration and the AUC/MIC ratio (r=0.427, p=0.010), the vancomycin through concentrations at the steady state within the therapeutic ranges did not mean the vancomycin AUC/MIC ratio within the therapeutic ranges (p=0.580). No significant difference was observed in the microbiological cure, all-cause mortality, and incidence of acute kidney injury in each group. Conclusion : The trough level-guided monitoring of the vancomycin should be replaced by the AUC/MIC ratio-guided monitoring in the clinical practice in Korea.