PURPOSE: Two methods of calculating vancomycin clearance were compared to determine the best body weight measure to use when dosing vancomycin for overweight and obese patients. METHODS: Hospitalized veterans weighing more than 120% of their ideal body weight (IBW) with serum vancomycin concentrations (SVCs) drawn between January 1, 2003, and June 30, 2005, were eligible for study inclusion. Exclusion criteria included weight of more than 300% the IBW, unstable renal function, dialysis, uncertain vancomycin dosing or sampling times, and distribution-phase sampling. Data from January 1 through December 31, 2003 (phase 1) determined the best-fit weight for vancomycin clearance for the Leonard and Boro method. The bias and precision of the modified Leonard and Boro method using the best-fit weight for vancomycin clearance were then compared with those of the Rushing and Ambrose method for predicting SVCs from January 1, 2004, through June 30, 2005 (phase 2). RESULTS: Forty-eight patients were included in phase 1, with 67 SVCs for analysis. During phase 1, adjusted body weight (ABW), using the Leonard and Boro method, was superior in predicting vancomycin clearance and the resultant SVCs. A total of 96 patients were included in phase 2 of the study, with 160 SVCs for analysis. The modified Leonard and Boro method was significantly more precise than the Rushing and Ambrose method in predicting vancomycin clearance. CONCLUSION: Use of ABW proved to be superior compared with total body weight when estimating vancomycin clearance in overweight and obese patients. While there was no difference in bias between methods, the modified Leonard and Boro method was significantly more precise than the Rushing and Ambrose method in predicting SVCs when dosing vancomycin for obese patients.
PURPOSE: Two methods of calculating vancomycin clearance were compared to determine the best body weight measure to use when dosing vancomycin for overweight and obesepatients. METHODS: Hospitalized veterans weighing more than 120% of their ideal body weight (IBW) with serum vancomycin concentrations (SVCs) drawn between January 1, 2003, and June 30, 2005, were eligible for study inclusion. Exclusion criteria included weight of more than 300% the IBW, unstable renal function, dialysis, uncertain vancomycin dosing or sampling times, and distribution-phase sampling. Data from January 1 through December 31, 2003 (phase 1) determined the best-fit weight for vancomycin clearance for the Leonard and Boro method. The bias and precision of the modified Leonard and Boro method using the best-fit weight for vancomycin clearance were then compared with those of the Rushing and Ambrose method for predicting SVCs from January 1, 2004, through June 30, 2005 (phase 2). RESULTS: Forty-eight patients were included in phase 1, with 67 SVCs for analysis. During phase 1, adjusted body weight (ABW), using the Leonard and Boro method, was superior in predicting vancomycin clearance and the resultant SVCs. A total of 96 patients were included in phase 2 of the study, with 160 SVCs for analysis. The modified Leonard and Boro method was significantly more precise than the Rushing and Ambrose method in predicting vancomycin clearance. CONCLUSION: Use of ABW proved to be superior compared with total body weight when estimating vancomycin clearance in overweight and obesepatients. While there was no difference in bias between methods, the modified Leonard and Boro method was significantly more precise than the Rushing and Ambrose method in predicting SVCs when dosing vancomycin for obesepatients.
Authors: Niels Westra; Johannes H Proost; Casper F M Franssen; Erik B Wilms; Marjolijn van Buren; Daan J Touw Journal: PLoS One Date: 2019-05-14 Impact factor: 3.240
Authors: Alexander H Flannery; Drayton A Hammond; Douglas R Oyler; Chenghui Li; Adrian Wong; Andrew P Smith; Qiu Min Yeo; Whitney Chaney; Caitlin E Pfaff; Angela M Plewa-Rusiecki; Paul Juang Journal: Infect Dis (Auckl) Date: 2020-09-25
Authors: Stephen W Davies; Jimmy T Efird; Christopher A Guidry; Zachary C Dietch; Rhett N Willis; Puja M Shah; Sara A Hennessy; Robert G Sawyer Journal: Surg Infect (Larchmt) Date: 2015-09-01 Impact factor: 2.150
Authors: Riley D Bowers; April A Cooper; Catherine L Wente; Dustin T Wilson; Steven W Johnson; Richard H Drew Journal: Pharm Pract (Granada) Date: 2018-08-13
Authors: Jessica K Ortwine; Evan J Zasowski; Jason M Pogue; Claudia Hanni; Chris Giuliano; Anthony M Casapao; Ryan Mynatt; Michael J Rybak Journal: Infect Dis Ther Date: 2019-10-21