PMID: 8947974Nov 1, 1996Paper

Vancomycin-binding characteristics in patients with serious infections

Pharmacotherapy
L LiA L Zaritsky

Abstract

To examine the extent, variability, and factors affecting vancomycin protein binding. Prospective, open-label, cohort study. A general hospital. Forty-four adults [mean (+/- SD) age 50.9 +/- 17.1 yrs, range 16.8-92.0 yrs] with serious infections. Unbound (Vu) and total (Vtot) vancomycin concentrations were determined by fluorescence polarization immunoassay. A statistical analysis model used the maximum likelihood method to evaluate the association between several important variables and log Vu while controlling for log Vtot effects. The mean fraction percentage of unbound vancomycin was 79.5 +/- 6.0% (range 53.0-96.3%). While controlling for Vtot the total variability of Vu was 8.3%, suggesting that vancomycin binding is relatively constant in sick adults. We were able to demonstrate a significant statistical interaction effect between gender and globulin protein concentration on Vu (p = 0.022). Globulin protein concentration in men was negatively associated with Vu (p = 0.0009), but there was no association in women (p = 0.645). Age, race, peak-trough association, serum creatinine, serum albumin, serum prealbumin, and hemodialysis were not significantly associated with log Vu in the statistical model. Compared with earlier st...Continue Reading

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