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首页> 外文期刊>Journal of pharmaceutical care. >Vancomycin Utilization Evaluation: Are We Dosing Appropriately?
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Vancomycin Utilization Evaluation: Are We Dosing Appropriately?

机译：万古霉素利用率评估：我们是否适当用药？

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Background: Inappropriate use of vancomycin not only increase health care costs but also contribute to the emergence of resistant organisms. Higher trough serum vancomycin concentrations (>10mg/L) has been recommended for avoidance of development of resistance. We aim to compare the administered dose with recommended doses based on guideline-recommended weight-based dosing.Methods: In a cross sectional study, all patients who received vancomycin between July and October 2013, in infectious disease, internal medicine wards and emergency department of a teaching hospital in Tehran, Iran were entered to the study. Indication of vancomycin and necessary data for dose calculation including height and serum creatinine were recorded. Prescribed doses were compared with recommended doses in guidelines and calculated Glomerular filtration rate (GFR) for each patient.Results: One hundred and four patients (45 females and 59 males) recruited in the study. Our results indicated that, from all administered doses of vancomycin, 64.4% and 88.8% differs significantly (more than 20%) based on American Pharmacist Association (AphA) vancomycin monograph and guideline-recommended, weight-based vancomycin dosing (for adults), respectively.Conclusion: Underdosing of vancomycin is a major risk factor for developing resistance of gram positive organisms to this glycopeptide. Our results showed that more than half of patients receiving vancomycin are in the risk of low drug levels based on guidelines. So, having a comprehensive plan for the proper use of this drug especially designing effective internal guidelines can prevent emergence of resistance to vancomycin in future.
机译：背景：万古霉素的不当使用不仅会增加医疗保健成本，而且还会导致耐药菌的出现。为了避免产生耐药性，建议较高的谷血清万古霉素浓度（> 10mg / L）。方法：在一项横断面研究中，所有2013年7月至2013年10月间在传染病，内科病房和急诊科接受万古霉素治疗的患者均接受横断面研究伊朗德黑兰的一家教学医院参加了这项研究。记录万古霉素的指示和用于剂量计算的必要数据，包括身高和血清肌酐。将指导中的处方剂量与推荐剂量进行比较，并为每位患者计算肾小球滤过率（GFR）。结果：研究共招募了104位患者（45位女性和59位男性）。我们的结果表明，根据美国药师协会（AphA）万古霉素专着和指南推荐的基于体重的万古霉素剂量（成人），在所有万古霉素剂量中，有64.4％和88.8％的差异显着（超过20％），结论：万古霉素剂量不足是发展革兰氏阳性生物对该糖肽耐药的主要危险因素。我们的结果表明，根据指南，接受万古霉素治疗的患者中有一半以上处于低药物风险。因此，有一个适当计划该药物的全面计划，尤其是设计有效的内部指南，可以防止将来对万古霉素产生抗药性。

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