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Altered vancomycin dose vs. serum concentration relationship in burn patients
1St. Francis Regional Medical Center, Department of Pharmacy, Wichita, KS 67214.
Clinical Pharmacology and Therapeutics
|July 1, 1988
Summary
Patients with serious thermal injury (burns) require higher and more frequent doses of vancomycin due to faster drug elimination. Individualized vancomycin dosing is crucial for effective treatment in burn patients.
Area of Science:
- Pharmacology
- Critical Care Medicine
- Burn Management
Background:
- Drug elimination can be altered in patients with severe thermal injuries.
- Increased drug clearance and shortened half-life are potential consequences.
Purpose of the Study:
- To prospectively compare vancomycin pharmacokinetics in burn patients versus medical/surgical patients.
- To determine if burn patients require different vancomycin dosing strategies.
Main Methods:
- Nine burn patients and eight medical/surgical patients with normal renal function were studied.
- Vancomycin doses were adjusted to maintain specific peak and trough serum concentrations.
- Demographic characteristics, creatinine clearance, and vancomycin levels were assessed.
Main Results:
- Burn patients required significantly higher daily doses of vancomycin (p < 0.02).
- Burn patients needed significantly more frequent dosing to maintain therapeutic ranges (p < 0.02).
- Vancomycin elimination half-life was significantly shorter in burn patients (p < 0.001).
Conclusions:
- Burn patients exhibit significantly altered vancomycin elimination, necessitating higher and more frequent dosing.
- Therapeutic drug monitoring of vancomycin serum concentrations is essential for successful outcomes in burn patients.
- Individualized vancomycin therapy is recommended due to unpredictable pharmacokinetics in burn populations.