Therapeutic drug monitoring of vancomycin in the case of augmented renal clearance: a case report of a paediatric patient.
Hasan MemişAhmet ÇakırAyşe ÜlgeyPublished in: European journal of hospital pharmacy : science and practice (2024)
Augmented renal clearance (ARC) is a condition in which renal circulation increases, causing drug levels in the blood to remain at subtherapeutic levels in severe trauma patients. Vancomycin, a hydrophilic anti-Gram-positive drug, has been shown in the literature to have its levels fall below the therapeutic range in the case of ARC. However, vancomycin dosing recommendations in the case of ARC are still lacking. Here, we identify an ARC case measured with urinary creatinine clearance in a severe trauma paediatric patient, causing vancomycin blood trough levels to drop. We could not be able to increase the vancomycin trough levels with intermittent dosing; hence, we administered vancomycin with continuous infusion, and this resulted in vancomycin blood trough levels remaining in the therapeutic range. No adverse effect was seen. Continuous infusion of vancomycin can be safely administered to paediatric patients in these cases.
Keyphrases
- methicillin resistant staphylococcus aureus
- emergency department
- intensive care unit
- trauma patients
- low dose
- end stage renal disease
- staphylococcus aureus
- case report
- chronic kidney disease
- newly diagnosed
- early onset
- mass spectrometry
- metabolic syndrome
- liquid chromatography
- adverse drug
- patient reported outcomes
- multidrug resistant