Factors impacting unbound vancomycin concentrations in different patient populations

Antimicrobial Agents and Chemotherapy
Matthijs OyaertSteven Pauwels

Abstract

The unbound drug hypothesis states that only unbound drug concentrations are active and available for clearance, and highly variable results regarding unbound vancomycin fractions have been reported in the literature. We have determined the unbound vancomycin fractions in four different patient groups by a liquid chromatography tandem mass spectrometry (LC-MS/MS) method and identified factors that modulate vancomycin binding. We have further developed and validated a prediction model to estimate unbound vancomycin concentrations. Vancomycin (unbound and total) concentrations were measured in 90 patients in four different hospital wards (hematology [n = 33 samples], intensive care unit [ICU] [n = 51], orthopedics [n = 44], and pediatrics [age range, 6 months to 14 years; n = 18]) by a validated LC-MS/MS method. Multiple linear mixed model analysis was performed to identify patient variables that were predictive of unbound vancomycin fractions and concentrations. The variables included in the model were patient age, ward, number of coadministered drugs with high protein binding, kidney function (estimated glomerular filtration rate [determined by Chronic Kidney Disease Epidemiology Collaboration formula]), alpha-1-acid glycoprote...Continue Reading

References

Jun 1, 1991·Antimicrobial Agents and Chemotherapy·E M BaileyG W Kaatz
Jul 1, 1990·Antimicrobial Agents and Chemotherapy·T G CantúD M Kornhauser
Apr 1, 1988·Drug Intelligence & Clinical Pharmacy·B H AckermanA A Pappas
Jul 1, 1969·The Journal of Allergy·S C MinesP Fireman
May 1, 1993·Antimicrobial Agents and Chemotherapy·H SunA R Krusell
Mar 8, 2005·The Journal of Antimicrobial Chemotherapy·R G Finch, G M Eliopoulos
Dec 3, 2005·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Michael J Rybak
May 20, 2008·International Journal of Antimicrobial Agents·Ian M Gould
Sep 29, 2009·International Journal of Antimicrobial Agents·Karine BerthoinStephane Carryn
Dec 28, 2010·European Journal of Pharmaceutical Sciences : Official Journal of the European Federation for Pharmaceutical Sciences·Henning BlumeChristoph Siethoff
Jan 7, 2011·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Catherine LiuUNKNOWN Infectious Diseases Society of America
May 4, 2011·Antimicrobial Agents and Chemotherapy·Markus A ZeitlingerUrsula Theuretzbacher
Jun 15, 2011·Antimicrobial Agents and Chemotherapy·Jill M ButterfieldThomas P Lodise
Apr 25, 2013·Clinical Chemistry and Laboratory Medicine : CCLM·Katrin KönigMichael Vogeser
Sep 4, 2013·Journal of Clinical Pharmacology·Martin G KeesCharlotte Kloft
Jul 30, 2014·Therapeutic Drug Monitoring·Veronique StoveAlain G Verstraete
Sep 4, 2014·Antimicrobial Agents and Chemotherapy·Kim VanstraelenIsabel Spriet
Dec 20, 2014·Clinica Chimica Acta; International Journal of Clinical Chemistry·Matthijs OyaertSteven Pauwels

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Citations

Feb 16, 2018·CPT: Pharmacometrics & Systems Pharmacology·Chie EmotoTsuyoshi Fukuda
Sep 25, 2018·Journal of Clinical Pharmacology·Jennifer Le, John S Bradley
Jan 16, 2019·Archives of Pathology & Laboratory Medicine·Tina Brencic, Nora Nikolac
Jun 4, 2019·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Keith A Rodvold
Jun 21, 2019·Paediatric Drugs·Kannan SridharanHusain Am Al Ajooz
Jun 9, 2017·AACN Advanced Critical Care·Uyen DiepKatlynd M Sunjic
Jul 14, 2019·European Journal of Drug Metabolism and Pharmacokinetics·Kannan SridharanSindhan Veeramuthu
May 18, 2018·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·Anne SmitsKarel Allegaert
Dec 22, 2016·The Journal of Antimicrobial Chemotherapy·Pieter A J G De CockPeter De Paepe
May 11, 2018·Acta Clinica Belgica·Karel Allegaert, John van den Anker
Jul 25, 2019·Pharmacology Research & Perspectives·Jackelien E van der MastWouter Bult
Jan 6, 2021·Pharmaceutics·Miriam AyusoSteven Van Cruchten

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