Acta Medica Okayama volume74 issue4
2020-08 発行

Successful Vancomycin Dose Adjustment in a Sepsis patient with Bacterial Meningitis Using Cystatin C

Chuma, Masayuki Clinical Research Center for Developmental Therapeutics, Tokushima University Hospital
Kondo, Masateru Department of Pharmacy, Tokushima University Hospital
Zamami, Yoshito Department of Pharmacy, Tokushima University Hospital
Takechi, Kenshi Clinical Research Center for Developmental Therapeutics, Tokushima University Hospital
Goda, Mitsuhiro Department of Pharmacy, Tokushima University Hospital
Okada, Naoto Department of Pharmacy, Tokushima University Hospital
Shibata, Akitomo Department of Pharmacy, Saiseikai Kumamoto Hospital
Asada, Mizuho Department of Pharmacy, Medical Hospital, Tokyo Medical and Dental University
Oto, Jun Department of Emergency and Critical Care Medicine, Tokushima University Graduate School of Biomedical Sciences
Yanagawa, Hiroaki Clinical Research Center for Developmental Therapeutics, Tokushima University Hospital
Ishizawa, Keisuke Department of Pharmacy, Tokushima University Hospital
Publication Date
2020-08
Abstract
Cystatin C-guided vancomycin (VCM) dosing is useful in critically ill patients. Its usefulness in septic patients with bacterial meningitis remains unknown, as there are no published reports. In this study, we sought to clarify its benefit. Cystatin C was used to guide VCM dosing in a septic bacterial meningitis patient with normal kidney function, according to therapeutic drug monitoring (TDM). Using cystatin C, the Bayesian method-based TDM made optimal VCM dosing possible, and decreased the predicted error (4.85 mg/L) compared to serum creatinine (16.83 mg/L). We concluded TDM of VCM using cystatin C can be considered in sepsis patients with bacterial meningitis with normal kidney function.
Document Type
Case Report
Keywords
vancomycin,
therapeutic drug monitoring
cystatin C
bacterial meningitis
sepsis
Link to PubMed
Thumnail 74_4_365.pdf 1.94 MB