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Vancomycin Pharmacokinetic Parameters in Patients with Hemorrhagic Stroke

Kathryn A Morbitzer1,2, J Dedrick Jordan3, Kelly A Sullivan1

  • 1Department of Pharmacy, UNC Health Care, Chapel Hill, NC, USA.

Neurocritical Care
|March 5, 2016
PubMed
Abstract

Insights

Vancomycin is often used for infections in hemorrhagic stroke patients. This study found that these patients eliminate vancomycin faster than expected, potentially leading to underdosing and treatment failure.

Area of Science:

  • Pharmacokinetics
  • Infectious Diseases
  • Neurology

Background:

  • Infections are a frequent complication in patients with hemorrhagic stroke.
  • Vancomycin is a common empiric therapy for these infections.

Purpose of the Study:

  • To assess the pharmacokinetic parameters of vancomycin in patients suffering from hemorrhagic stroke.
  • To compare predicted vancomycin pharmacokinetics with actual patient data.

Main Methods:

  • Retrospective analysis of adult patients with aneurysmal subarachnoid hemorrhage (aSAH) or intracerebral hemorrhage (ICH).
  • Comparison of predicted pharmacokinetic parameters with those calculated from serum trough concentrations.
  • Inclusion criteria: patients admitted between May 2010 and February 2015 who received vancomycin.

Main Results:

  • Eighty aSAH and 66 ICH patients were included.
  • In both aSAH and ICH groups, measured vancomycin trough concentrations were significantly lower than predicted.
  • Calculated elimination rate constants were higher and half-lives were shorter than predicted in both patient groups.

Conclusions:

  • Hemorrhagic stroke patients exhibit altered vancomycin pharmacokinetics, characterized by increased drug elimination.
  • This accelerated elimination may lead to subtherapeutic vancomycin levels, increasing the risk of treatment failure and complications.
  • Current dosing regimens may require adjustment in hemorrhagic stroke patients to ensure adequate vancomycin exposure.
Keywords:
Hemorrhagic strokeIntracerebral hemorrhagePharmacokineticsSubarachnoid hemorrhageVancomycin

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