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The Effect of Hypoalbuminemia on the Therapeutic Concentration and Dosage of Vancomycin in Critically Ill Septic Patients in Low-Resource Countries

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2019
3343.pdf (165.7Kb)
Authors
Kovačević, Tijana
Miljković, Branislava
Mikov, Momir
Stojisavljević-Satara, Svjetlana
Dragić, Sasa
Momcicević, Danica
Kovacević, Peđa
Article (Published version)
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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.

Keywords:
severe hypoalbuminemia / vancomycin / therapeutic drug monitoring / sepsis / critical illness
Source:
Dose-Response, 2019, 17, 2
Publisher:
  • Sage Publications Inc, Thousand Oaks

DOI: 10.1177/1559325819850419

ISSN: 1559-3258

PubMed: 31205457

WoS: 000468927300001

Scopus: 2-s2.0-85067646752
[ Google Scholar ]
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URI
http://farfar.pharmacy.bg.ac.rs/handle/123456789/3345
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  • Radovi istraživača / Researchers’ publications
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Pharmacy

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