TY  - JOUR
AU  - Milaković, Dragana
AU  - Kovačević, Tijana
AU  - Kovačević, Peđa
AU  - Barišić, Vedrana
AU  - Avram, Sanja
AU  - Dragić, Saša
AU  - Zlojutro, Biljana
AU  - Momčičević, Danica
AU  - Miljković, Branislava
AU  - Vučićević, Katarina
PY  - 2024
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/5557
AB  - During veno-venous extracorporeal membrane oxygenation (vv ECMO) therapy, antimicrobial drugs are frequently used, and appropriate dosing is challenging due to there being limited data to support the dosage. Linezolid is effective against multidrug-resistant Gram-positive pathogens frequently isolated in ECMO patients. In total, 53 steady-state linezolid levels were obtained following 600 mg intravenous (IV) injections every 8 h, and these were used to develop a population pharmacokinetic (PopPK) model in patients with COVID-19-associated acute respiratory distress syndrome (CARDS) on vv ECMO. The data were analyzed using a nonlinear mixed-effects modelling approach. Monte Carlo simulation generated 5000 patients’ individual PK parameters and corresponding concentration–time profiles using the PopPK model, following the administration of 600 mg/8 h (a higher-than-standard dosing) and 600 mg/12 h (standard). The probabilities of pharmacokinetic/pharmacodynamic (PK/PD) target attainment (PTA) and the cumulative fraction of responses (CFR) for three pathogens were calculated and compared between the two dosing scenarios. Linezolid 600 mg/8 h was predicted to achieve greater than or equal to 85%Tf>MIC in at least 90% of the patients with CARDS on vv ECMO compared to only approximately two thirds of the patients after dosing every 12 h at a minimal inhibitory concentration (MIC) of 2 mg/L. In addition, for the same MIC, fAUC24/MIC ≥ 80 was achieved in almost three times the number of patients following an 8-h versus a 12-h interval. PopPK simulation predicted that a significantly higher proportion of the patients with CARDS on vv ECMO would achieve the PK/PD targets following the 8-h dosing interval compared to standard linezolid dosing. Nevertheless, the safety concern, in particular, for thrombocytopenia, with higher-than-standard linezolid dosage is reasonable, and consequently, monitoring is essential.
PB  - MDPI
T2  - Pharmaceutics
T1  - Population Pharmacokinetic Model of Linezolid and Probability of Target Attainment in Patients with COVID-19-Associated Acute Respiratory Distress Syndrome on Veno-Venous Extracorporeal Membrane Oxygenation—A Step toward Correct Dosing
VL  - 16
IS  - 2
DO  - 10.3390/pharmaceutics16020253
ER  - 

@article{
author = "Milaković, Dragana and Kovačević, Tijana and Kovačević, Peđa and Barišić, Vedrana and Avram, Sanja and Dragić, Saša and Zlojutro, Biljana and Momčičević, Danica and Miljković, Branislava and Vučićević, Katarina",
year = "2024",
abstract = "During veno-venous extracorporeal membrane oxygenation (vv ECMO) therapy, antimicrobial drugs are frequently used, and appropriate dosing is challenging due to there being limited data to support the dosage. Linezolid is effective against multidrug-resistant Gram-positive pathogens frequently isolated in ECMO patients. In total, 53 steady-state linezolid levels were obtained following 600 mg intravenous (IV) injections every 8 h, and these were used to develop a population pharmacokinetic (PopPK) model in patients with COVID-19-associated acute respiratory distress syndrome (CARDS) on vv ECMO. The data were analyzed using a nonlinear mixed-effects modelling approach. Monte Carlo simulation generated 5000 patients’ individual PK parameters and corresponding concentration–time profiles using the PopPK model, following the administration of 600 mg/8 h (a higher-than-standard dosing) and 600 mg/12 h (standard). The probabilities of pharmacokinetic/pharmacodynamic (PK/PD) target attainment (PTA) and the cumulative fraction of responses (CFR) for three pathogens were calculated and compared between the two dosing scenarios. Linezolid 600 mg/8 h was predicted to achieve greater than or equal to 85%Tf>MIC in at least 90% of the patients with CARDS on vv ECMO compared to only approximately two thirds of the patients after dosing every 12 h at a minimal inhibitory concentration (MIC) of 2 mg/L. In addition, for the same MIC, fAUC24/MIC ≥ 80 was achieved in almost three times the number of patients following an 8-h versus a 12-h interval. PopPK simulation predicted that a significantly higher proportion of the patients with CARDS on vv ECMO would achieve the PK/PD targets following the 8-h dosing interval compared to standard linezolid dosing. Nevertheless, the safety concern, in particular, for thrombocytopenia, with higher-than-standard linezolid dosage is reasonable, and consequently, monitoring is essential.",
publisher = "MDPI",
journal = "Pharmaceutics",
title = "Population Pharmacokinetic Model of Linezolid and Probability of Target Attainment in Patients with COVID-19-Associated Acute Respiratory Distress Syndrome on Veno-Venous Extracorporeal Membrane Oxygenation—A Step toward Correct Dosing",
volume = "16",
number = "2",
doi = "10.3390/pharmaceutics16020253"
}

Milaković, D., Kovačević, T., Kovačević, P., Barišić, V., Avram, S., Dragić, S., Zlojutro, B., Momčičević, D., Miljković, B.,& Vučićević, K.. (2024). Population Pharmacokinetic Model of Linezolid and Probability of Target Attainment in Patients with COVID-19-Associated Acute Respiratory Distress Syndrome on Veno-Venous Extracorporeal Membrane Oxygenation—A Step toward Correct Dosing. in Pharmaceutics
MDPI., 16(2).
https://doi.org/10.3390/pharmaceutics16020253

Milaković D, Kovačević T, Kovačević P, Barišić V, Avram S, Dragić S, Zlojutro B, Momčičević D, Miljković B, Vučićević K. Population Pharmacokinetic Model of Linezolid and Probability of Target Attainment in Patients with COVID-19-Associated Acute Respiratory Distress Syndrome on Veno-Venous Extracorporeal Membrane Oxygenation—A Step toward Correct Dosing. in Pharmaceutics. 2024;16(2).
doi:10.3390/pharmaceutics16020253 .

Milaković, Dragana, Kovačević, Tijana, Kovačević, Peđa, Barišić, Vedrana, Avram, Sanja, Dragić, Saša, Zlojutro, Biljana, Momčičević, Danica, Miljković, Branislava, Vučićević, Katarina, "Population Pharmacokinetic Model of Linezolid and Probability of Target Attainment in Patients with COVID-19-Associated Acute Respiratory Distress Syndrome on Veno-Venous Extracorporeal Membrane Oxygenation—A Step toward Correct Dosing" in Pharmaceutics, 16, no. 2 (2024),
https://doi.org/10.3390/pharmaceutics16020253 . .

TY  - JOUR
AU  - Guntschnig, Sonja
AU  - Antoniadis, Vasilis
AU  - Falamic, Slaven
AU  - Kovačević, Tijana
AU  - Kurczewska-Michalak, Marta
AU  - Miljković, Branislava
AU  - Olearova, Anna
AU  - Sviestina, Inese
AU  - Szucs, Attila
AU  - Bampali, Konstantina
AU  - Tiszai, Zita
AU  - Volmer, Daisy
AU  - Wiela-Hojeńska, Anna
AU  - Fialova, Daniela
AU  - Vlcek, Jiri
AU  - Stuhec, Matej
AU  - Hogg, Anita
AU  - Scott, Michael
AU  - Stewart, Derek
AU  - Mair, Alpana
AU  - Ravera, Silvia
AU  - Lery, François-Xavier
AU  - Kardas, Przemysław
PY  - 2023
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/4984
AB  - Clinical pharmacy as an area of practice, education and research started developing around the 1960s when pharmacists across the globe gradually identified the need to focus more on ensuring the appropriate use of medicines to improve patient outcomes rather than being engaged in manufacturing and supply. Since that time numerous studies have shown the positive impact of clinical pharmacy services (CPS). The need for wider adoption of CPS worldwide becomes urgent, as the global population ages, and the prevalence of polypharmacy as well as shortage of healthcare professionals is rising. At the same time, there is great pressure to provide both high-quality and cost-effective health services. All these challenges urgently require the adoption of a new paradigm of healthcare system architecture. One of the most appropriate answers to these challenges is to increase the utilization of the potential of highly educated and skilled professionals widely available in these countries, i.e., pharmacists, who are well positioned to prevent and manage drug-related problems together with ensuring safe and effective use of medications with further care relating to medication adherence. Unfortunately, CPS are still underdeveloped and underutilized in some parts of Europe, namely, in most of the Central and Eastern European (CEE) countries. This paper reviews current situation of CPS development in CEE countries and the prospects for the future of CPS in that region.
PB  - Frontiers Media SA
T2  - Frontiers in Pharmacology
T1  - Recommendations for wider adoption of clinical pharmacy in Central and Eastern Europe in order to optimise pharmacotherapy and improve patient outcomes
VL  - 14
DO  - 10.3389/fphar.2023.1244151
ER  - 

@article{
author = "Guntschnig, Sonja and Antoniadis, Vasilis and Falamic, Slaven and Kovačević, Tijana and Kurczewska-Michalak, Marta and Miljković, Branislava and Olearova, Anna and Sviestina, Inese and Szucs, Attila and Bampali, Konstantina and Tiszai, Zita and Volmer, Daisy and Wiela-Hojeńska, Anna and Fialova, Daniela and Vlcek, Jiri and Stuhec, Matej and Hogg, Anita and Scott, Michael and Stewart, Derek and Mair, Alpana and Ravera, Silvia and Lery, François-Xavier and Kardas, Przemysław",
year = "2023",
abstract = "Clinical pharmacy as an area of practice, education and research started developing around the 1960s when pharmacists across the globe gradually identified the need to focus more on ensuring the appropriate use of medicines to improve patient outcomes rather than being engaged in manufacturing and supply. Since that time numerous studies have shown the positive impact of clinical pharmacy services (CPS). The need for wider adoption of CPS worldwide becomes urgent, as the global population ages, and the prevalence of polypharmacy as well as shortage of healthcare professionals is rising. At the same time, there is great pressure to provide both high-quality and cost-effective health services. All these challenges urgently require the adoption of a new paradigm of healthcare system architecture. One of the most appropriate answers to these challenges is to increase the utilization of the potential of highly educated and skilled professionals widely available in these countries, i.e., pharmacists, who are well positioned to prevent and manage drug-related problems together with ensuring safe and effective use of medications with further care relating to medication adherence. Unfortunately, CPS are still underdeveloped and underutilized in some parts of Europe, namely, in most of the Central and Eastern European (CEE) countries. This paper reviews current situation of CPS development in CEE countries and the prospects for the future of CPS in that region.",
publisher = "Frontiers Media SA",
journal = "Frontiers in Pharmacology",
title = "Recommendations for wider adoption of clinical pharmacy in Central and Eastern Europe in order to optimise pharmacotherapy and improve patient outcomes",
volume = "14",
doi = "10.3389/fphar.2023.1244151"
}

Guntschnig, S., Antoniadis, V., Falamic, S., Kovačević, T., Kurczewska-Michalak, M., Miljković, B., Olearova, A., Sviestina, I., Szucs, A., Bampali, K., Tiszai, Z., Volmer, D., Wiela-Hojeńska, A., Fialova, D., Vlcek, J., Stuhec, M., Hogg, A., Scott, M., Stewart, D., Mair, A., Ravera, S., Lery, F.,& Kardas, P.. (2023). Recommendations for wider adoption of clinical pharmacy in Central and Eastern Europe in order to optimise pharmacotherapy and improve patient outcomes. in Frontiers in Pharmacology
Frontiers Media SA., 14.
https://doi.org/10.3389/fphar.2023.1244151

Guntschnig S, Antoniadis V, Falamic S, Kovačević T, Kurczewska-Michalak M, Miljković B, Olearova A, Sviestina I, Szucs A, Bampali K, Tiszai Z, Volmer D, Wiela-Hojeńska A, Fialova D, Vlcek J, Stuhec M, Hogg A, Scott M, Stewart D, Mair A, Ravera S, Lery F, Kardas P. Recommendations for wider adoption of clinical pharmacy in Central and Eastern Europe in order to optimise pharmacotherapy and improve patient outcomes. in Frontiers in Pharmacology. 2023;14.
doi:10.3389/fphar.2023.1244151 .

Guntschnig, Sonja, Antoniadis, Vasilis, Falamic, Slaven, Kovačević, Tijana, Kurczewska-Michalak, Marta, Miljković, Branislava, Olearova, Anna, Sviestina, Inese, Szucs, Attila, Bampali, Konstantina, Tiszai, Zita, Volmer, Daisy, Wiela-Hojeńska, Anna, Fialova, Daniela, Vlcek, Jiri, Stuhec, Matej, Hogg, Anita, Scott, Michael, Stewart, Derek, Mair, Alpana, Ravera, Silvia, Lery, François-Xavier, Kardas, Przemysław, "Recommendations for wider adoption of clinical pharmacy in Central and Eastern Europe in order to optimise pharmacotherapy and improve patient outcomes" in Frontiers in Pharmacology, 14 (2023),
https://doi.org/10.3389/fphar.2023.1244151 . .

TY  - JOUR
AU  - Kovačević, Tijana
AU  - Miljković, Branislava
AU  - Kovačević, Peđa
AU  - Dragić, Saša
AU  - Momčićević, Danica
AU  - Avram, Sanja
AU  - Jovanović, Marija
AU  - Vučićević, Katarina
PY  - 2020
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/4826
AB  - Purpose: The present study aimed to establish a population pharmacokinetic model of vancomycin, including adult critically ill septic patients, with normal and impaired renal function.

Materials and methods: A prospective analysis of 146 concentrations from 73 adult critically ill septic patients treated with 1-h intravenous infusion of vancomycin were included in the study. A nonlinear mixed effects modeling (NONMEM) approach was applied for data analysis and evaluation of the final model. The influence of creatinine clearance calculated by the Cockcroft-Gault equation (CrCl), and other potential covariates on vancomycin clearance (CL) were evaluated.

Results: The final one-compartment pharmacokinetic model includes the effect of CrCl on CL. Population pharmacokinetic values for a typical subject were estimated at 0.024 l/h for CL dependent on renal function (CLCrCl), 1.93 l/h for residual portion of CL (not dependent on renal function), and 0.511 l/kg for volume of distribution (V). According to the final model, for patients with CrCl = 120 ml/min, the median vancomycin total CL is 4.81 l/h, while CrCl-dependent fraction accounts for approximately 60% of CL.

Conclusions: The developed population vancomycin model may be used in estimating individual CL for adult critically ill septic patients, and could be applied for individualizing dosage regimens taking into account the continuous effect of CrCl.
PB  - Elsevier Inc.
T2  - Journal of Critical Care
T1  - Population pharmacokinetic model of Vancomycin based on therapeutic drug monitoring data in critically ill septic patients
VL  - 55
SP  - 116
EP  - 121
DO  - 10.1016/j.jcrc.2019.10.012
ER  - 

@article{
author = "Kovačević, Tijana and Miljković, Branislava and Kovačević, Peđa and Dragić, Saša and Momčićević, Danica and Avram, Sanja and Jovanović, Marija and Vučićević, Katarina",
year = "2020",
abstract = "Purpose: The present study aimed to establish a population pharmacokinetic model of vancomycin, including adult critically ill septic patients, with normal and impaired renal function.

Materials and methods: A prospective analysis of 146 concentrations from 73 adult critically ill septic patients treated with 1-h intravenous infusion of vancomycin were included in the study. A nonlinear mixed effects modeling (NONMEM) approach was applied for data analysis and evaluation of the final model. The influence of creatinine clearance calculated by the Cockcroft-Gault equation (CrCl), and other potential covariates on vancomycin clearance (CL) were evaluated.

Results: The final one-compartment pharmacokinetic model includes the effect of CrCl on CL. Population pharmacokinetic values for a typical subject were estimated at 0.024 l/h for CL dependent on renal function (CLCrCl), 1.93 l/h for residual portion of CL (not dependent on renal function), and 0.511 l/kg for volume of distribution (V). According to the final model, for patients with CrCl = 120 ml/min, the median vancomycin total CL is 4.81 l/h, while CrCl-dependent fraction accounts for approximately 60% of CL.

Conclusions: The developed population vancomycin model may be used in estimating individual CL for adult critically ill septic patients, and could be applied for individualizing dosage regimens taking into account the continuous effect of CrCl.",
publisher = "Elsevier Inc.",
journal = "Journal of Critical Care",
title = "Population pharmacokinetic model of Vancomycin based on therapeutic drug monitoring data in critically ill septic patients",
volume = "55",
pages = "116-121",
doi = "10.1016/j.jcrc.2019.10.012"
}

Kovačević, T., Miljković, B., Kovačević, P., Dragić, S., Momčićević, D., Avram, S., Jovanović, M.,& Vučićević, K.. (2020). Population pharmacokinetic model of Vancomycin based on therapeutic drug monitoring data in critically ill septic patients. in Journal of Critical Care
Elsevier Inc.., 55, 116-121.
https://doi.org/10.1016/j.jcrc.2019.10.012

Kovačević T, Miljković B, Kovačević P, Dragić S, Momčićević D, Avram S, Jovanović M, Vučićević K. Population pharmacokinetic model of Vancomycin based on therapeutic drug monitoring data in critically ill septic patients. in Journal of Critical Care. 2020;55:116-121.
doi:10.1016/j.jcrc.2019.10.012 .

Kovačević, Tijana, Miljković, Branislava, Kovačević, Peđa, Dragić, Saša, Momčićević, Danica, Avram, Sanja, Jovanović, Marija, Vučićević, Katarina, "Population pharmacokinetic model of Vancomycin based on therapeutic drug monitoring data in critically ill septic patients" in Journal of Critical Care, 55 (2020):116-121,
https://doi.org/10.1016/j.jcrc.2019.10.012 . .

TY  - JOUR
AU  - Kovačević, Tijana
AU  - Vezmar-Kovačević, Sandra
AU  - Stanetić, Mirko
AU  - Kovačević, Peđa
AU  - Miljković, Branislava
PY  - 2020
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/3594
AB  - Background: This study aimed to demonstrate that having clinical pharmacist as a member of oncology team in low and middle income countries might lead to significant reduction in the number of erlotinib interactions in the treatment of non-small cell lung cancer patients. Methods: A group of 44 patients was labeled as intervention group and they were analyzed prospectively in the period from 1 January 2017 to 1 May 2018 during clinical pharmacist’s participation in regular weekly multidisciplinary oncology team meetings. The control group consisted of 44 out of 110 patients treated with erlotinib before the involvement of a clinical pharmacist in oncology team, match paired with 44 patients in intervention group. Results: Clinically significant interactions were identified in two-thirds of studied patients (57 out of 88). Most drug interactions, 38%, potentially result in decrease of serum concentration of erlotinib. Clinical pharmacist provided therapy modification suggestions for 32 out of 44 (72.72%) patients in the intervention group, most of which were accepted by doctors. In the intervention group, there were significantly less clinically significant interactions compared to the control group (10 versus 24, p = 0.002). Progression-free survival was significantly longer in the pharmacist’s intervention group (p = 0.001). Conclusions: Clinical pharmacist’s intervention led to significant decrease in erlotinib interactions which may result in treatment optimization of lung cancer patients
PB  - SAGE Publications Ltd
T2  - Journal of Oncology Pharmacy Practice
T1  - Impact of pharmacist’s intervention on decreasing erlotinib interactions in the treatment of lung cancer patients in low resource settings
DO  - 10.1177/1078155220921545
ER  - 

@article{
author = "Kovačević, Tijana and Vezmar-Kovačević, Sandra and Stanetić, Mirko and Kovačević, Peđa and Miljković, Branislava",
year = "2020",
abstract = "Background: This study aimed to demonstrate that having clinical pharmacist as a member of oncology team in low and middle income countries might lead to significant reduction in the number of erlotinib interactions in the treatment of non-small cell lung cancer patients. Methods: A group of 44 patients was labeled as intervention group and they were analyzed prospectively in the period from 1 January 2017 to 1 May 2018 during clinical pharmacist’s participation in regular weekly multidisciplinary oncology team meetings. The control group consisted of 44 out of 110 patients treated with erlotinib before the involvement of a clinical pharmacist in oncology team, match paired with 44 patients in intervention group. Results: Clinically significant interactions were identified in two-thirds of studied patients (57 out of 88). Most drug interactions, 38%, potentially result in decrease of serum concentration of erlotinib. Clinical pharmacist provided therapy modification suggestions for 32 out of 44 (72.72%) patients in the intervention group, most of which were accepted by doctors. In the intervention group, there were significantly less clinically significant interactions compared to the control group (10 versus 24, p = 0.002). Progression-free survival was significantly longer in the pharmacist’s intervention group (p = 0.001). Conclusions: Clinical pharmacist’s intervention led to significant decrease in erlotinib interactions which may result in treatment optimization of lung cancer patients",
publisher = "SAGE Publications Ltd",
journal = "Journal of Oncology Pharmacy Practice",
title = "Impact of pharmacist’s intervention on decreasing erlotinib interactions in the treatment of lung cancer patients in low resource settings",
doi = "10.1177/1078155220921545"
}

Kovačević, T., Vezmar-Kovačević, S., Stanetić, M., Kovačević, P.,& Miljković, B.. (2020). Impact of pharmacist’s intervention on decreasing erlotinib interactions in the treatment of lung cancer patients in low resource settings. in Journal of Oncology Pharmacy Practice
SAGE Publications Ltd..
https://doi.org/10.1177/1078155220921545

Kovačević T, Vezmar-Kovačević S, Stanetić M, Kovačević P, Miljković B. Impact of pharmacist’s intervention on decreasing erlotinib interactions in the treatment of lung cancer patients in low resource settings. in Journal of Oncology Pharmacy Practice. 2020;.
doi:10.1177/1078155220921545 .

Kovačević, Tijana, Vezmar-Kovačević, Sandra, Stanetić, Mirko, Kovačević, Peđa, Miljković, Branislava, "Impact of pharmacist’s intervention on decreasing erlotinib interactions in the treatment of lung cancer patients in low resource settings" in Journal of Oncology Pharmacy Practice (2020),
https://doi.org/10.1177/1078155220921545 . .

TY  - JOUR
AU  - Kovačević, Tijana
AU  - Miljković, Branislava
AU  - Mikov, Momir
AU  - Stojisavljević-Satara, Svjetlana
AU  - Dragić, Sasa
AU  - Momcicević, Danica
AU  - Kovacević, Peđa
PY  - 2019
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/3345
AB  - Purpose: To determine whether severe hypoalbuminemia ( lt 25 mg/L) has a significant effect on serum levels of vancomycin and whether it can effect vancomycin dosage regimen and the loading dose administration. Material and Methods: Prospective, cohort, and a single-center study included 61 patients whose vancomycin serum levels were measured in steady state. Vancomycin trough levels (C-min) that were in the range 15 to 20 mu g/mL were considered therapeutic and trough levels higher than 15 mu g/mL were considered potentially nephrotoxic. Results: In the group of patients with severe hypoalbuminemia, C-min was significantly higher compared to the those with nonsevere hypoalbuminemia (>25 mg/L; 23.04 [19.14] vs 13.28 [11.28], P = .01). In the group of patients who received the vancomycin loading dose of 2 g, C-min was significantly higher in patients with severe hypoalbuminemia compared to the patients with nonsevere hypoalbuminemia (34.52 [25.93] vs 15.37 [10.48], P = .04). Conclusion: In critically ill septic patients with severe hypoalbuminemia, there is a high probability that the loading dose of vancomycin is not necessary since it is associated with potentially toxic vancomycin C-min, while in the patients with nonsevere hypoalbuminemia the loading dose may be necessary to achieving therapeutic C-min.
PB  - Sage Publications Inc, Thousand Oaks
T2  - Dose-Response
T1  - The Effect of Hypoalbuminemia on the Therapeutic Concentration and Dosage of Vancomycin in Critically Ill Septic Patients in Low-Resource Countries
VL  - 17
IS  - 2
DO  - 10.1177/1559325819850419
ER  - 

@article{
author = "Kovačević, Tijana and Miljković, Branislava and Mikov, Momir and Stojisavljević-Satara, Svjetlana and Dragić, Sasa and Momcicević, Danica and Kovacević, Peđa",
year = "2019",
abstract = "Purpose: To determine whether severe hypoalbuminemia ( lt 25 mg/L) has a significant effect on serum levels of vancomycin and whether it can effect vancomycin dosage regimen and the loading dose administration. Material and Methods: Prospective, cohort, and a single-center study included 61 patients whose vancomycin serum levels were measured in steady state. Vancomycin trough levels (C-min) that were in the range 15 to 20 mu g/mL were considered therapeutic and trough levels higher than 15 mu g/mL were considered potentially nephrotoxic. Results: In the group of patients with severe hypoalbuminemia, C-min was significantly higher compared to the those with nonsevere hypoalbuminemia (>25 mg/L; 23.04 [19.14] vs 13.28 [11.28], P = .01). In the group of patients who received the vancomycin loading dose of 2 g, C-min was significantly higher in patients with severe hypoalbuminemia compared to the patients with nonsevere hypoalbuminemia (34.52 [25.93] vs 15.37 [10.48], P = .04). Conclusion: In critically ill septic patients with severe hypoalbuminemia, there is a high probability that the loading dose of vancomycin is not necessary since it is associated with potentially toxic vancomycin C-min, while in the patients with nonsevere hypoalbuminemia the loading dose may be necessary to achieving therapeutic C-min.",
publisher = "Sage Publications Inc, Thousand Oaks",
journal = "Dose-Response",
title = "The Effect of Hypoalbuminemia on the Therapeutic Concentration and Dosage of Vancomycin in Critically Ill Septic Patients in Low-Resource Countries",
volume = "17",
number = "2",
doi = "10.1177/1559325819850419"
}

Kovačević, T., Miljković, B., Mikov, M., Stojisavljević-Satara, S., Dragić, S., Momcicević, D.,& Kovacević, P.. (2019). The Effect of Hypoalbuminemia on the Therapeutic Concentration and Dosage of Vancomycin in Critically Ill Septic Patients in Low-Resource Countries. in Dose-Response
Sage Publications Inc, Thousand Oaks., 17(2).
https://doi.org/10.1177/1559325819850419

Kovačević T, Miljković B, Mikov M, Stojisavljević-Satara S, Dragić S, Momcicević D, Kovacević P. The Effect of Hypoalbuminemia on the Therapeutic Concentration and Dosage of Vancomycin in Critically Ill Septic Patients in Low-Resource Countries. in Dose-Response. 2019;17(2).
doi:10.1177/1559325819850419 .

Kovačević, Tijana, Miljković, Branislava, Mikov, Momir, Stojisavljević-Satara, Svjetlana, Dragić, Sasa, Momcicević, Danica, Kovacević, Peđa, "The Effect of Hypoalbuminemia on the Therapeutic Concentration and Dosage of Vancomycin in Critically Ill Septic Patients in Low-Resource Countries" in Dose-Response, 17, no. 2 (2019),
https://doi.org/10.1177/1559325819850419 . .