Efficacy of Vancomycin on Gram-Positive Bacterial Infection in Elderly Critical Patients and Risk Factors Associated With Nephrotoxicity
Author(s):
Min Huang , Hao Wu , Jing Zhou , Min Xu* , Suming Zhou
Article Type:
Research/Original Article (دارای رتبه معتبر)
Abstract:
Background
Vancomycin is widely used for infections caused by gram-positive bacteria, but little attention has been paid to vancomycin in the treatment of critically ill patients aged ≥80 years. The aim of the current study was to investigate the efficacy of vancomycin and risk factors associated with nephrotoxicity of vancomycin in elderly critically ill patients.Methods
A retrospective study was performed in a 14-bed medical-surgical geriatric ICU between January 2007 and June 2014. The patients (aged ≥80 years) were included if they received ≥4 doses of vancomycin and the therapy duration was ≥ 2 hours.Results
The clinical efficacy was 74.0% (37/50). The 28-day mortality was 26.0% (13/50). Of the patients, 24% (12/50) had nephrotoxicity during vancomycin treatment period. The clinical efficacy was 60%, 86.7%, 58.3%, and 33.3%, and the 28-day mortality rate was 20%, 23.3%, 33.3%, and 33.3%, respectively, when the trough concentrations were ≤10 μg/mL, 1015 μg/mL, 1520 μg/mL, and ≥20 μg/mL. The multivariate logistic regression analysis showed that an Acute Physiology and Chronic Health Evaluation (APACHE) II score ≥25 points, vancomycin trough concentrations ≥15 μg/mL, and the combined use of diuretics (furosemide ≥40 mg/d) were independent risk factors leading to nephrotoxicity.Conclusion
We did not find that higher vancomycin trough concentrations lead to better clinical outcomes in elderly critically ill patients. Increased vancomycin trough concentrations, high APACHE II scores, and the combined use of diuretics may increase the risks of nephrotoxicity in elderly critically ill patients.Keywords:
Language:
English
Published:
Archives of Iranian Medicine, Volume:21 Issue: 8, Aug 2018
Pages:
349 to 355
magiran.com/p1874432
دانلود و مطالعه متن این مقاله با یکی از روشهای زیر امکان پذیر است:
اشتراک شخصی
با عضویت و پرداخت آنلاین حق اشتراک یکساله به مبلغ 1,390,000ريال میتوانید 70 عنوان مطلب دانلود کنید!
اشتراک سازمانی
به کتابخانه دانشگاه یا محل کار خود پیشنهاد کنید تا اشتراک سازمانی این پایگاه را برای دسترسی نامحدود همه کاربران به متن مطالب تهیه نمایند!
توجه!
- حق عضویت دریافتی صرف حمایت از نشریات عضو و نگهداری، تکمیل و توسعه مگیران میشود.
- پرداخت حق اشتراک و دانلود مقالات اجازه بازنشر آن در سایر رسانههای چاپی و دیجیتال را به کاربر نمیدهد.
دسترسی سراسری کاربران دانشگاه پیام نور!
اعضای هیئت علمی و دانشجویان دانشگاه پیام نور در سراسر کشور، در صورت ثبت نام با ایمیل دانشگاهی، تا پایان فروردین ماه 1403 به مقالات سایت دسترسی خواهند داشت!
In order to view content subscription is required
Personal subscription
Subscribe magiran.com for 70 € euros via PayPal and download 70 articles during a year.
Organization subscription
Please contact us to subscribe your university or library for unlimited access!