Correlation analysis of pharmacokinetics of norvancomycin in cerebrospinal fluid and clinical efficacy
Author(s): Deng Sijun, Wan Yongzhan
Pages: 1542-1544
Year: 2015 Issue: 10
Journal: China Medicine
Keyword: Norvancomycin; Cerebrospinal fluid; Pharmacokinetics; Clinical curative effect; Correlation;
Abstract: Objective To analyze the correlation between pharmacokinetics of norvancomycin in cerebrospinal fluid (CSF) and clinical efficacy.Methods Totally 40 young patients suffering from methicillin resistant staphylococcus aureus infection from February to December 2014 were given a single dose of vancomycin intravenous infusion (0.8 g).The norvancomycin drug concentration in CSF was measured;the pharmacokinetic data were calculated and their correlations with the efficacy were analyzed.Results The high vancomycin concentration range of the standard curve in CSF solution was (64 ± 4) mg/L;the linear regression equation was Y=8.371 3X + 6.845 7,r =0.999 1;the relative standard deviation in intra-day,inter-day and inter-week was ≤4.58％,≤ 5.38％,≤ 7.93％,respectively.The norvancomycin concentration in CSF was (43.6 ± 7.0) mg/L immediately after intravenous use of the drug,and it decreased to (22.9 ±4.2) mg/L after 1 hour,(6.5 ± 1.3) mg/L after 12 hours and (3.1 ± 0.9) mg/L after 24 hours;the drug concentration in CSF after 36 hours was lower than the value of detectable concentration in all patients.The half-life,apparent volume of distribution,area under the concentration time curve (AUC),drug total clearance rate and 24 h renal clearance rate were (0.35 ±0.08) h,(9.9 ±2.2) L,(198 ±20) mg/L · h,(87 ±22) ml/min and (76 ± 17) ml/min,respectively.The total efficiency was 90.0％ (36/40) and no adverse reactions occurred.Linear regression analysis showed that AUC and drug total clearance rate were the main influence factors of clinical curative effect (OR =1.893,2.154;P ＜ 0.05).Conclusion The pharmacokinetic parameters of vancomycin in CSF are related to clinical efficacy;pharmacokinetic monitoring of vancomycin concentration in CSF should be applied to guild the adjustment of dosage regimen to improve the prognosis.
Pages: 1542-1544
Year: 2015 Issue: 10
Journal: China Medicine
Keyword: Norvancomycin; Cerebrospinal fluid; Pharmacokinetics; Clinical curative effect; Correlation;
Abstract: Objective To analyze the correlation between pharmacokinetics of norvancomycin in cerebrospinal fluid (CSF) and clinical efficacy.Methods Totally 40 young patients suffering from methicillin resistant staphylococcus aureus infection from February to December 2014 were given a single dose of vancomycin intravenous infusion (0.8 g).The norvancomycin drug concentration in CSF was measured;the pharmacokinetic data were calculated and their correlations with the efficacy were analyzed.Results The high vancomycin concentration range of the standard curve in CSF solution was (64 ± 4) mg/L;the linear regression equation was Y=8.371 3X + 6.845 7,r =0.999 1;the relative standard deviation in intra-day,inter-day and inter-week was ≤4.58％,≤ 5.38％,≤ 7.93％,respectively.The norvancomycin concentration in CSF was (43.6 ± 7.0) mg/L immediately after intravenous use of the drug,and it decreased to (22.9 ±4.2) mg/L after 1 hour,(6.5 ± 1.3) mg/L after 12 hours and (3.1 ± 0.9) mg/L after 24 hours;the drug concentration in CSF after 36 hours was lower than the value of detectable concentration in all patients.The half-life,apparent volume of distribution,area under the concentration time curve (AUC),drug total clearance rate and 24 h renal clearance rate were (0.35 ±0.08) h,(9.9 ±2.2) L,(198 ±20) mg/L · h,(87 ±22) ml/min and (76 ± 17) ml/min,respectively.The total efficiency was 90.0％ (36/40) and no adverse reactions occurred.Linear regression analysis showed that AUC and drug total clearance rate were the main influence factors of clinical curative effect (OR =1.893,2.154;P ＜ 0.05).Conclusion The pharmacokinetic parameters of vancomycin in CSF are related to clinical efficacy;pharmacokinetic monitoring of vancomycin concentration in CSF should be applied to guild the adjustment of dosage regimen to improve the prognosis.
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