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

2019
Authors
Kovačević, TijanaMiljković, Branislava

Mikov, Momir
Stojisavljević-Satara, Svjetlana
Dragić, Sasa
Momcicević, Danica
Kovacević, Peđa
Article (Published version)
Metadata
Show full item recordAbstract
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 illnessSource:
Dose-Response, 2019, 17, 2Publisher:
- Sage Publications Inc, Thousand Oaks
DOI: 10.1177/1559325819850419
ISSN: 1559-3258
PubMed: 31205457