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. 1996 Jan;40(1):186–190. doi: 10.1128/aac.40.1.186

Pharmacokinetics of vancomycin in adult cystic fibrosis patients.

R A Pleasants 1, E L Michalets 1, D M Williams 1, W M Samuelson 1, J R Rehm 1, M R Knowles 1
PMCID: PMC163080  PMID: 8787903

Abstract

Although the depositions of many antibiotics are altered in cystic fibrosis patients, that of vancomycin has not been studied. To assess vancomycin pharmacokinetics, 10 adult cystic fibrosis patients were given a parenteral dose of vancomycin (15 mg/kg) during the first 72 h of hospitalization for acute bronchopulmonary exacerbation. Blood samples were obtained at 0, 1, 1.25, 1.5, 2, 3, 4, 6, 8, 12, 15, and 24 h. The mean (standard deviation) weight, measured creatinine clearance, and Taussig clinical score were 51 (13) kg, 130 (39) ml/min/1.73 m2, and 64 (13), respectively. Multicompartmental pharmacokinetic parameters were best described by a two-compartment model. The mean (standard deviation) volume of distribution, total body clearance, and terminal elimination rate constant were 0.58 (0.15) liter/kg, 91 (19) ml/min/1.73 m2, and 0.123 (0.05) h-1, respectively. These values were consistent with vancomycin pharmacokinetic parameters obtained in previous studies of healthy adult volunteers. Vancomycin dosages predicted by using a two-compartment Bayesian model were approximately 15 mg/kg every 8 to 12 h. There were poor correlations between clinical score or creatinine clearance and any pharmacokinetic parameter (r values of < 0.32). The coefficient of correlation between urine flow rate and total body clearance was 0.7 (P < 0.05). Adult cystic fibrosis patients exhibit a disposition of vancomycin similar to that exhibited by healthy adults, and thus cystic fibrosis does not alter vancomycin pharmacokinetics.

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Selected References

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  1. Ballestero S., Villaverde R., Escobar H., Baquero F. Susceptibility to various antimicrobial agents of Staphylococcus aureus isolates from cystic fibrosis patients. Eur J Clin Microbiol Infect Dis. 1992 Dec;11(12):1193–1194. doi: 10.1007/BF01961145. [DOI] [PubMed] [Google Scholar]
  2. Boeckh M., Lode H., Borner K., Höffken G., Wagner J., Koeppe P. Pharmacokinetics and serum bactericidal activity of vancomycin alone and in combination with ceftazidime in healthy volunteers. Antimicrob Agents Chemother. 1988 Jan;32(1):92–95. doi: 10.1128/aac.32.1.92. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Boxerbaum B., Jacobs M. R., Cechner R. L. Prevalence and significance of methicillin-resistant Staphylococcus aureus in patients with cystic fibrosis. Pediatr Pulmonol. 1988;4(3):159–163. doi: 10.1002/ppul.1950040307. [DOI] [PubMed] [Google Scholar]
  4. Brasfield D., Hicks G., Soong S., Tiller R. E. The chest roentgenogram in cystic fibrosis: a new scoring system. Pediatrics. 1979 Jan;63(1):24–29. [PubMed] [Google Scholar]
  5. Cantú T. G., Yamanaka-Yuen N. A., Lietman P. S. Serum vancomycin concentrations: reappraisal of their clinical value. Clin Infect Dis. 1994 Apr;18(4):533–543. [PubMed] [Google Scholar]
  6. Golper T. A., Noonan H. M., Elzinga L., Gilbert D., Brummett R., Anderson J. L., Bennett W. M. Vancomycin pharmacokinetics, renal handling, and nonrenal clearances in normal human subjects. Clin Pharmacol Ther. 1988 May;43(5):565–570. doi: 10.1038/clpt.1988.74. [DOI] [PubMed] [Google Scholar]
  7. Healy D. P., Polk R. E., Garson M. L., Rock D. T., Comstock T. J. Comparison of steady-state pharmacokinetics of two dosage regimens of vancomycin in normal volunteers. Antimicrob Agents Chemother. 1987 Mar;31(3):393–397. doi: 10.1128/aac.31.3.393. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Kearns G. L. Hepatic drug metabolism in cystic fibrosis: recent developments and future directions. Ann Pharmacother. 1993 Jan;27(1):74–79. doi: 10.1177/106002809302700117. [DOI] [PubMed] [Google Scholar]
  9. Matzke G. R., McGory R. W., Halstenson C. E., Keane W. F. Pharmacokinetics of vancomycin in patients with various degrees of renal function. Antimicrob Agents Chemother. 1984 Apr;25(4):433–437. doi: 10.1128/aac.25.4.433. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Moellering R. C., Jr Monitoring serum vancomycin levels: climbing the mountain because it is there? Clin Infect Dis. 1994 Apr;18(4):544–546. doi: 10.1093/clinids/18.4.544. [DOI] [PubMed] [Google Scholar]
  11. Pedersen S. S., Jensen T., Osterhammel D., Osterhammel P. Cumulative and acute toxicity of repeated high-dose tobramycin treatment in cystic fibrosis. Antimicrob Agents Chemother. 1987 Apr;31(4):594–599. doi: 10.1128/aac.31.4.594. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Rodvold K. A., Blum R. A., Fischer J. H., Zokufa H. Z., Rotschafer J. C., Crossley K. B., Riff L. J. Vancomycin pharmacokinetics in patients with various degrees of renal function. Antimicrob Agents Chemother. 1988 Jun;32(6):848–852. doi: 10.1128/aac.32.6.848. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Rotschafer J. C., Crossley K., Zaske D. E., Mead K., Sawchuk R. J., Solem L. D. Pharmacokinetics of vancomycin: observations in 28 patients and dosage recommendations. Antimicrob Agents Chemother. 1982 Sep;22(3):391–394. doi: 10.1128/aac.22.3.391. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Rybak M. J., Albrecht L. M., Berman J. R., Warbasse L. H., Svensson C. K. Vancomycin pharmacokinetics in burn patients and intravenous drug abusers. Antimicrob Agents Chemother. 1990 May;34(5):792–795. doi: 10.1128/aac.34.5.792. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. SHWACHMAN H., KULCZYCKI L. L. Long-term study of one hundred five patients with cystic fibrosis; studies made over a five- to fourteen-year period. AMA J Dis Child. 1958 Jul;96(1):6–15. doi: 10.1001/archpedi.1958.02060060008002. [DOI] [PubMed] [Google Scholar]
  16. Sahai J., Healy D. P., Garris R., Berry A., Polk R. E. Influence of antihistamine pretreatment on vancomycin-induced red-man syndrome. J Infect Dis. 1989 Nov;160(5):876–881. doi: 10.1093/infdis/160.5.876. [DOI] [PubMed] [Google Scholar]
  17. Sawchuk R. J., Zaske D. E., Cipolle R. J., Wargin W. A., Strate R. G. Kinetic model for gentamicin dosing with the use of individual patient parameters. Clin Pharmacol Ther. 1977 Mar;21(3):362–369. doi: 10.1002/cpt1977213362. [DOI] [PubMed] [Google Scholar]
  18. Smith A. L. Antibiotic therapy in cystic fibrosis: evaluation of clinical trials. J Pediatr. 1986 May;108(5 Pt 2):866–870. doi: 10.1016/s0022-3476(86)80759-4. [DOI] [PubMed] [Google Scholar]
  19. Taussig L. M., Kattwinkel J., Friedewald W. T., Di Sant'Agnese P. A. A new prognostic score and clinical evaluation system for cystic fibrosis. J Pediatr. 1973 Mar;82(3):380–390. doi: 10.1016/s0022-3476(73)80110-6. [DOI] [PubMed] [Google Scholar]

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