INTRAVENOUS ADMINISTRATION OF VANCOMYCIN FOR POSTOPERATIVE MRSA INFECTION WITH MONITORING SERUM CONCENTRATION

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  • 血中濃度モニタリングを指標とした術後MRSA感染症に対するVancomycin静注療法

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Abstract

For ten patients with postoperative infection caused by methicillin-resistant staphylococcus aureus (MRSA), 500 mg of vancomycin (VCM) was administered intravenously every 12 hours by 60-minute infusion. Serum concentrations of VCM were measured time-dependently. In eight patients with normal renal function, whose creatinine clearance (Ccr) levels were above 50ml/min, the mean values of peak concentrations were ranged from 22 to 26μg/ml with no abnormal accumulation. The mean values of trough concentrations (<10μg/ml) on days 14 and 21 increased significantly (p<0.01) than those on day 1. In two patients with impaired renal function, whose Ccr levels were below 40ml/min, both the peak and trough concentrations increased and accumulated. When the trough concentration increased to 10μg/ml or more, VCM was withdrawn. In all patients, no side effects such as nephrotoxicity occurred. Minimum inhibitory concentrations of VCM were ranged from 0.78 to 1.56μg/ml. Every trough concentration was within a therapeutic range.<br> Our method of VCM administration for postoperative MRSA infection is safe and effective for patients with normal renal function. The monitoring of serum concentrations that may decide the dosage of VCM is neccesary for patients with impaired renal function.

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