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한국인에서 Vancomycin의 치료적 약물농도 평가

Other Titles
 Therapeutic Drug Monitoring of Vancomycin in Korean Patients 
Authors
 송영구  ;  김혜경  ;  김준명  ;  윤희정  ;  박민수  ;  김정호  ;  안보숙  ;  이서영  ;  노은경 
Citation
 INFECTION AND CHEMOTHERAPY (감염과 화학요법), Vol.36(5) : 311-318, 2004 
Journal Title
 INFECTION AND CHEMOTHERAPY (감염과 화학요법) 
ISSN
 1598-8112 
Issue Date
2004
Keywords
Therapeutic drug monitoring ; Pharmacokinetics ; Vancomycin
Abstract
Background:We measured plasma vancomycin concentrations as a part of therapeutic drug monitoring (TDM) consultation and compared and analyzed the estimated plasma steady-state therapeutic drug levels of vancomycin obtained on the basis of measured concentrations and by population PK parameters using a PK simulation software in Korean patients to find the factors influencing the discrepancies that lie between these estimates. Materials and Methods:We analyzed the PK parameters of the 188 patients for whom vancomycin TDM was done for 239 episodes between March, 2001 and September, 2002. The trough vancomycin plasma concentrations were measured from plasma samples that were drawn 30 minutes before a vancomycin dose. Based on the measured concentrations, we estimated the steady-state therapeutic levels (ECm) and PK parameters (apparent volumes of distribution, Vdm; clearance, Clm; and half life, T1/2m) using the single-point linear method utilized in CAPCIL (Simkin, Inc.) software program. We compared these with the steady-state levels and PK parameters estimated based on population PK database supplied by the software (ECp, Vdp, Clp, and T1/2p). We stratified and compared the values based on the patients' renal functions, body weights relative to ideal body weights, the magnitude of differences between ECm and ECp. Multiple logistic regression using SAS software package was done to analyze factors that significantly influence the discrepancies. Results:One hundred and eleven were males, and 77 were females. The mean ECm were significantly lower than the mean ECp (11.9±9.9 μg/ml vs. 19.2±19.5 μg/ml). Clm and Vdm were higher than Clp and Vdp, respectively. The same patterns could be applied to the subclasses of patients based on renal functions and body weights. The factors that contribute to the differences in ECm and ECp were body weight, age, height, IBW, BUN, and Clcr, of which age, body weight, and BUN were found to be most significant by multiple regression analysis. Conclusions:Significant sizes of discrepancies between the estimated plasma steady-state therapeutic drug levels of vancomycin obtained on the basis of measured concentrations and by population PK parameters using a PK simulation software in Korean patients necessitate adjustment of dosage and confirmation of steady-state levels by follow-up TDM. We emphasize the need for obtaining vancomycin population PK database in Korean patients.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jeong Ho(김정호) ORCID logo https://orcid.org/0000-0003-2479-0548
Kim, June Myung(김준명)
Park, Min Soo(박민수) ORCID logo https://orcid.org/0000-0002-4395-9938
Song, Young Goo(송영구) ORCID logo https://orcid.org/0000-0002-0733-4156
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/112404
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