Vancomycin: the need to suit serum concentrations in hemodialysis patients

The฀vancomycin฀dose฀for฀hemodialysis฀(HD)฀patients฀should฀be฀adjusted฀by฀monitoring฀drug฀serum฀ concentrations.฀ However,฀ this฀ procedure฀ is฀ not฀ available฀ in฀ most฀ health฀ services฀ in฀ Brazil,฀ which฀ usually฀adopts฀protocols฀based฀on฀published฀studies.฀The฀trials฀available฀are฀controversial,฀and฀several฀have฀not฀been฀conducted฀with฀current฀dialyzers.฀This฀study฀aimed฀at฀assessing฀the฀suitability฀of฀ vancomycin฀serum฀concentrations฀in฀HD฀patients฀at฀a฀public฀hospital.฀Blood฀samples฀of฀HD฀patients฀ were฀collected฀from฀November฀2006฀to฀May฀2007,฀at฀time฀intervals฀of฀48,฀96,฀120,฀or฀168฀hours฀after฀ vancomycin฀administration.฀Drug฀measurement฀was฀performed฀with฀polarized฀light฀immunofl฀uorescence.฀Approximately฀86%฀of฀trough฀vancomycin฀serum฀concentrations฀were฀below฀the฀r ecommended฀value,฀indicating฀exposure฀to฀subtherapeutic฀doses฀and฀a฀higher฀risk฀for฀selecting฀resistant฀ microorganisms.