Iindividualized dose of Vancomycin for Patientâs with Chronic Kidney Disease at a Government Hospital in Padang, West Sumatra, Indonesia

Vancomycin is a narrow therapeutical index antibiotic used to treat a number of bacterial infections. This glycopeptide antibiotic is indicated for the medication of severe life-threatening infections by gram positive bacteria insensitives to other antibiotics. It is almost completely eliminated unchanged by renal. Vancomycin has potential toxic characteristic in patients with renal dysfunction. The aim of the study was to examine individualized dose of vancomycin in patients with chronic kidney disease at internal ward in a government hospital Padang. Computation of dose following pharmacokinetics dosing method. The research was arranged by observational retrospective method analyzed from 58 patient’s medical record during January 2015 – April 2016. 43 patients (74.1%) of chronic kidney disease were medicated using vancomycin. Patients of chronic kidney disease on stage of 2, 3, 4 and 5 were 12, 15, 6 and 10, respectively. Clearance of vancomycin in patients with chronic kidney disease on stage of 2, 3, 4 and 5 were 3.06 + 0.4, 1.88 + 0.28, 0.88 + 0.21, and 0.58 + 0.15 L/h, respectively. The elimination half-life of this drug on chronic kidney disease stage 2, 3, 4 and 5 patients were 9.65 + 2.09, 14.11 + 2.89, 24.48 + 5.44, and 51.27 + 17.16 h, respectively. While accumulation factor in patients with chronic kidney disease on stage of 2, 3, 4 and 5 were 0.33 + 0.12, 0.50 + 0.1, 0.67 + 0.09, and 0.49 + 0.006, respectively. Results showed that 30.23% patients received exceed dose based on pharmacokinetic dosing method calculation