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Critical Care Medicine Aug 1993
Topics: Histamine Release; Humans; Hypotension; Vancomycin
PubMed: 7687945
DOI: 10.1097/00003246-199308000-00002 -
Clinical Pharmacokinetics Jun 1991The resurgence of the use of and interest in vancomycin, in conjunction with the high degree of interpatient variability in its pharmacokinetic profile, has prompted the... (Review)
Review
The resurgence of the use of and interest in vancomycin, in conjunction with the high degree of interpatient variability in its pharmacokinetic profile, has prompted the development of many and varied dosing methods. Several dosing nomograms have been proposed and evaluated, methods which are useful for initial dosing but do not allow for individualisation of dosage. Given these constraints, several investigators have attempted to apply conventional least-squares regression techniques and, more recently, Bayesian methodologies using either 1- or 2-compartment pharmacokinetic models. Comparative information evaluating algorithmic methods demonstrates that those of Moellering and Lake offer the least biased and most precise predictions of vancomycin dosage. Patient individualisation using conventional least-squares methodology offers some improvement over nomogram-based methods, both in predictive performance and in dosage adjustment once serum concentration data are available. Overall, the latest data indicate that regimens which incorporate Bayesian principles tend to give better results than nomogram-based or conventional least-squares dosing methods for this drug. Despite the advances in methods for dosing vancomycin, several questions remain to be answered. A lack of convincing evidence of a correlation between serum concentrations and therapeutic outcome has prompted debate over the need for serum concentration monitoring and, if it is needed, over which patient population would most benefit. Secondly, little comparative information is currently available as to the dosing of vancomycin in paediatric and neonatal patient populations. Several nomograms for initial dosing have been proposed, but only 2 have been subject to subsequent testing. Finally, information regarding cost-effectiveness and the quality of patient outcome is lacking from the current literature.
Topics: Bayes Theorem; Humans; Vancomycin
PubMed: 2044330
DOI: 10.2165/00003088-199120060-00003 -
Therapie 2011Vancomycin is an antibiotic for exclusive hospital use administrated in intravenous infusion to treat systemic infections. It is mainly eliminated by kidneys and... (Review)
Review
Vancomycin is an antibiotic for exclusive hospital use administrated in intravenous infusion to treat systemic infections. It is mainly eliminated by kidneys and potentially nephrotoxic. Data available show that Therapeutic Drug Monitoring (TDM) of vancomycin is highly recommended. It aims to ensure efficacy and avoid resistance by maintaining trough plasma concentrations above the MIC. Secondary, vancomycine TDM may be indicated to prevent nephrotoxicity in high risk patients. TDM is often underwent at steady state (48 to 72 h after the treatment initiation) unless in case of renal impairment (24 h). While compared with intermittent administration, continuous infusion did not result in prognosis improvement; however it resulted in lower pharmacokinetic variability and better cost-efficiency. Targeted trough concentrations for intermittent infusion are between 15 and 20 mg/L (up to 25-30 mg/L for GISA). In case of continuous infusion, targets are higher (25 to 40 mg/L).
Topics: Anti-Bacterial Agents; Bacterial Infections; Dose-Response Relationship, Drug; Drug Monitoring; Evidence-Based Medicine; Humans; Infusions, Intravenous; Kidney Diseases; Vancomycin
PubMed: 21466775
DOI: 10.2515/therapie/2011005 -
Journal of Medicinal Chemistry Mar 2024It is an urgent need to tackle the global crisis of multidrug-resistant bacterial infections. We report here an innovative strategy for large-scale screening of new...
It is an urgent need to tackle the global crisis of multidrug-resistant bacterial infections. We report here an innovative strategy for large-scale screening of new antibacterial agents using a whole bacteria-based DNA-encoded library (DEL) of vancomycin derivatives via peripheral modifications. A bacterial binding affinity assay was established to select the modification fragments in high-affinity compounds. The optimal resynthesized derivatives demonstrated excellently enhanced activity against various resistant bacterial strains and provided useful structures for vancomycin derivatization. This work presents the new concept in a natural product-templated DEL and in antibiotic discovery through bacterial affinity screening, which promotes the fight against drug-resistant bacteria.
Topics: Vancomycin; Anti-Bacterial Agents; Bacteria; Drug Resistance, Multiple, Bacterial; DNA; Microbial Sensitivity Tests
PubMed: 38482826
DOI: 10.1021/acs.jmedchem.3c02197 -
The Pan African Medical Journal 2020despite the development of new methods, culture on solid medium is the gold standard for the diagnosis of tuberculosis. However, this method is associated with increased...
INTRODUCTION
despite the development of new methods, culture on solid medium is the gold standard for the diagnosis of tuberculosis. However, this method is associated with increased rates of contamination of cultures by spore-forming bacteria. These bacteria are generally sensitive to vancomycin and to a combinsation of vancomycin, colistin, nystatin, and trimethoprim (VCNT). The purpose of this study was to assess the effectiveness of VCNT-based selective Lowenstein-Jensen (LJ) medium in reducing contamination of cultures by spore-forming bacteria.
METHODS
sputum samples, collected from the 120 TB and non-TB patients included in the study between October 2016 and May 2017, were decontaminated with the modified Petroff method. Decontamination pellets were inoculated onto conventional LJ media and selective VCNT-based LJ medium containing 10µg/ml vancomycin. Fifteen strains of spore-forming bacteria were inoculated onto the same media in order to assess their sensitivity to VCNT.
RESULTS
the contamination of cultures on VCNT-based LJ medium containing 10µg/ml of vancomycin and LJ medium were 11.66% (14/120) and 39.16% (47/120) with p <0.0001, respectively. Sensitivity of spore-forming bacteria to VCNT decreased with the increasing of culture incubation time.
CONCLUSION
VCNT-based selective LJ medium containing 10µg/ml vancomycin led to a significant reduction in the rate of culture contamination. This environment could contribute to improve the quality of mycobacterial cultures and thus bacteriological diagnosis of tuberculosis.
Topics: Anti-Bacterial Agents; Bacteriological Techniques; Culture Media; Humans; Mycobacterium tuberculosis; Spores; Sputum; Tuberculosis; Vancomycin
PubMed: 33738033
DOI: 10.11604/pamj.2020.37.345.23016 -
Journal of Medicinal Chemistry Aug 2023Drug resistant bacterial infections have emerged as one of the greatest threats to public health. The discovery and development of new antimicrobials and anti-infective...
Drug resistant bacterial infections have emerged as one of the greatest threats to public health. The discovery and development of new antimicrobials and anti-infective strategies are urgently needed to address this challenge. Vancomycin is one of the most important antibiotics for the treatment of Gram-positive infections. Here, we introduce the vancomycin-arginine conjugate (V-R) as a highly effective antimicrobial against actively growing mycobacteria and difficult-to-treat mycobacterial biofilm populations. Further improvement in efficacy through combination treatment of V-R to inhibit peptidoglycan synthesis and ethambutol to inhibit arabinogalactan synthesis underscores the ability to identify compound synergies to more effectively target the Achilles heel of the cell-wall assembly. Moreover, we introduce mechanistic activity data and a molecular model derived from a d-Ala-d-Ala-bound vancomycin structure that we hypothesize underlies the molecular basis for the antibacterial improvement attributed to the arginine modification that is specific to peptidoglycan chemistry employed by mycobacteria and distinct from Gram-positive pathogens.
Topics: Vancomycin; Peptidoglycan; Arginine; Anti-Bacterial Agents; Mycobacterium
PubMed: 37477249
DOI: 10.1021/acs.jmedchem.3c00565 -
Advanced Drug Delivery Reviews Dec 2000The objective of this contribution is to summarize the preparation and application of water-in-oil-in-water type multiple emulsions (w/o/w emulsions) entrapping... (Review)
Review
The objective of this contribution is to summarize the preparation and application of water-in-oil-in-water type multiple emulsions (w/o/w emulsions) entrapping vancomycin (VCM). Formulations of the emulsions (the composition of an oily phase or the type and concentrations of surfactants) and emulsification methods (a stirring method and a membrane method) or conditions (rotation rates, pore sizes of membrane or operation pressures) were evaluated in order to prepare stable w/o/w emulsions. The pharmaceutical properties of the w/o/w emulsions - particle sizes, viscosity, phase separation and drug entrapment efficiency were measured and evaluated. We prepared stable w/o/w emulsions with a particle size of about 3 micrometer and an entrapment efficiency of VCM of about 70%. When this emulsion was administered intravenously to rats, plasma concentrations of VCM were prolonged compared to the VCM solution alone. The results of this study show the potential of the w/o/w emulsions for several clinical applications as one of the drug delivery systems.
Topics: Animals; Drug Stability; Emulsions; Humans; Injections, Intramuscular; Injections, Intravenous; Rats; Solubility; Vancomycin
PubMed: 11104894
DOI: 10.1016/s0169-409x(00)00097-1 -
Antibiotiki I Khimioterapiia =... 1993
Topics: Contraindications; Drug Administration Routes; Drug Stability; Drug Synergism; Humans; Kidney Diseases; Microbial Sensitivity Tests; Vancomycin
PubMed: 8074554
DOI: No ID Found -
Frontiers in Immunology 2023Methicillin-resistant (MRSA) is a strain with resistance to beta-lactam antibiotics, making it a global human and veterinary health concern. Specifically,...
Identification of Vancomycin Resistance in Methicillin-resistant in two macaque species and decolonization and long-term prevention of recolonization in Cynomolgus Macaques ().
Methicillin-resistant (MRSA) is a strain with resistance to beta-lactam antibiotics, making it a global human and veterinary health concern. Specifically, immunosuppressed patients have a remarkably higher risk of clinical MRSA infections with significantly increased rates of prolonged clinical recovery, morbidity, and mortality. The current treatment of choice for MRSA is vancomycin. Importantly, we report the first known vancomycin-resistant (VRSA) carriers in a cohort of Mauritian cynomolgus macaques (CM) imported to the Oregon National Primate Research Center (ONPRC), with a MRSA carrier rate of 76.9% (10/13 animals). All MRSA isolates also demonstrated resistance to vancomycin with prevalence of vancomycin-intermediate (VISA) at 30% (3/10 MRSA-positive CMs) and VRSA at 70% (7/10 MRSA-positive CMs). Additionally, we identified VRSA in a rhesus macaque (RM) housed within the same room as the VRSA-positive CMs and identified a MRSA/VISA carrier rate of 18.8% in RMs (3/16 positive for both MRSA and VISA) in unexposed recently assigned animals directly from the ONPRC RM breeding colony. Considering that the MRSA and VRSA/VISA-positive CMs future study aims included significant immunosuppression, MRSA/VRSA/VISA decolonization treatment and expanded "MRSA-free" practices were employed to maintain this status. We report the first controlled study using in-depth analyses with appropriate diagnostic serial testing to definitively show an MRSA decolonization therapy (90% success rate) and expanded barrier practice techniques to successfully prevent recolonization (100%) of a cohort of CMs MRSA-free (up to 529 days with a total of 4,806 MRSA-free NHP days).
Topics: Animals; Humans; Macaca fascicularis; Methicillin-Resistant Staphylococcus aureus; Vancomycin Resistance; Macaca mulatta; Staphylococcus aureus; Vancomycin
PubMed: 37675101
DOI: 10.3389/fimmu.2023.1244637 -
Infectious Disease Clinics of North... Sep 1989Interest in vancomycin has been rekindled by the emergence of resistant gram-positive pathogens and the improvement in drug purity. The antimicrobial activity,... (Review)
Review
Interest in vancomycin has been rekindled by the emergence of resistant gram-positive pathogens and the improvement in drug purity. The antimicrobial activity, pharmacokinetics, clinical indications, dosing schedules, and adverse reactions of vancomycin are summarized.
Topics: Bacterial Infections; Gram-Positive Bacteria; Vancomycin
PubMed: 2671144
DOI: No ID Found