Vancomycin pharmacokinetics and dosing recommendations in patients undergoing hemodialysis

• Published in: Japanese Journal of Chemotherapy Vol. 51; no. 11; pp. 693 - 702
• Main Authors: Nakata, Koichiro, Kasuya, Yasuji, Takaichi, Kenmei, Katori, Hideyuki, Hayashi, Masahiro, Hara, Shigeko, Nakatani, Tatsuo, Igarashi, Masahiro
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of Chemotherapy 2003; 公益社団法人 日本化学療法学会
• Subjects: vancomycin; 薬物動態; 血液透析; 適正使用
• ISSN: 1340-7007; 1884-5886
• DOI: 10.11250/chemotherapy1995.51.693

We evaluated the performance of a vancomycin (VCM) dosing program in predicting dosages necessary to achieve desired serum VCM concentrations in five patients undergoing dialysis. Individual pharmacokinetic parameters were calculated after a first dose of 20mg/kg was administered. Appropriate dosages thereafter were determined using standard pharmacokinetic techniques based on predicted steady-state serum VCM concentrations. The predictive performance of the five patients verified the clinical application of this method. For patients undergoing hemodialysis three times a week, we recommend that VCM treatment be initiated with a first dose of 25mg/kg followed by a maintenance dose of 20mg/kg once a week. We also recommend that hemodialysis and nonhemodialysis clearance be determined to predict larger dosages appropriate for the treatment of patients with severe MRSA.