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Augmented Renal Clearance of Vancomycin in Hematologic Malignancy Patients
- Source :
- Biological and Pharmaceutical Bulletin. 42:2089-2094
- Publication Year :
- 2019
- Publisher :
- Pharmaceutical Society of Japan, 2019.
-
Abstract
- The pharmacokinetics of vancomycin (VAN) was retrospectively examined based on trough concentrations at large scale to identify pharmacokinetic differences between Japanese hematologic malignancy and non-malignancy patients. Data from 261 hematologic malignancy patients and 261 non-malignancy patients, including the patient's background, VAN dose, and pharmacokinetics of VAN estimated by an empirical Bayesian method, were collected and analyzed. Our results showed significantly higher values for VAN clearance and shorter elimination half-lives in patients with hematologic malignancies than non-malignancy patients. In addition, multiple regression analysis under adjusting for confounding factors by propensity score, showed that VAN clearance significantly increased in relation to hematologic malignancies. In conclusion, since in hematologic cancer patients VAN clearance is increased, the blood concentration of VAN becomes lower than expected and this may contribute to the survival of resistant bacteria when VAN is administered at low doses. These results suggest that early monitoring of VAN levels in hematologic cancer patients might be recommended to maintain desired effects without side-effects.
- Subjects :
- Adult
Male
0301 basic medicine
medicine.medical_specialty
Metabolic Clearance Rate
Pharmaceutical Science
Gastroenterology
03 medical and health sciences
0302 clinical medicine
Japan
Pharmacokinetics
Vancomycin
Internal medicine
medicine
Hematologic malignancy
Humans
In patient
Aged
Retrospective Studies
Aged, 80 and over
Pharmacology
business.industry
Confounding
General Medicine
Middle Aged
Anti-Bacterial Agents
Resistant bacteria
030104 developmental biology
Hematologic Neoplasms
030220 oncology & carcinogenesis
Propensity score matching
Female
Drug Monitoring
business
medicine.drug
Clearance
Subjects
Details
- ISSN :
- 13475215 and 09186158
- Volume :
- 42
- Database :
- OpenAIRE
- Journal :
- Biological and Pharmaceutical Bulletin
- Accession number :
- edsair.doi.dedup.....4f874684af2b6a7185d7f3732d6d2f01