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)
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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
WoS: 000468927300001
Scopus: 2-s2.0-85067646752
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PharmacyTY - 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 . .