Abstract:
WHAT IS KNOWN AND OBJECTIVE:The pharmacokinetic-pharmacodynamic parameter that best predicts the efficacy of vancomycin is the ratio of the area under the concentration versus time curve (AUC) to the minimum inhibitory concentration (MIC). A 24-h AUC (AUC24 )/MIC ratio ≥ 400 was recommended in an American consensus review, but vancomycin treatment occasionally fails despite maintenance of AUC24 /MIC ≥ 400. We evaluated the association between clinical efficacy of vancomycin and two novel pharmacokinetic parameters, the 'area under the trough level' (AUTL) and the 'area above the trough level' (AATL), in hospitalized elderly patients with methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. METHODS:The subjects were hospitalized elderly patients who were administered vancomycin for treatment of MRSA pneumonia between 2006 and 2012 at Sasebo Chuo Hospital (Nagasaki, Japan). Pharmacokinetic parameters of vancomycin were estimated for each patient by Bayesian analysis using population pharmacokinetic parameters for Japanese patients. Based on the patient-specific parameters thus obtained, AUC24 values were calculated as the vancomycin dosage divided by vancomycin clearance. AUTL was calculated as the trough serum concentration multiplied by 24 h, whereas AATL was calculated by subtracting AUTL from AUC24 . RESULTS AND DISCUSSION:Logistic regression analysis demonstrated that efficacy of vancomycin was more strongly associated with AUTL than AUC24 . The optimal cut-off value of AUTL was 331 μg∙h/mL, which means that the optimal cut-off value of the trough serum concentration was 13·8 μg/mL. WHAT IS NEW AND CONCLUSION:Efficacy of vancomycin was associated with AUTL, a novel pharmacokinetic parameter. Determining the target AUTL or trough concentration may enhance the efficacy of vancomycin therapy in elderly patients with MRSA pneumonia. Given that nephrotoxicity may increase with a Ctrough in excess of 15 μg/mL, this level should ideally not be exceeded.
journal_name
J Clin Pharm Therjournal_title
Journal of clinical pharmacy and therapeuticsauthors
Fukumori S,Tsuji Y,Mizoguchi A,Kasai H,Ishibashi T,Iwamura N,To Hdoi
10.1111/jcpt.12399subject
Has Abstractpub_date
2016-08-01 00:00:00pages
399-402issue
4eissn
0269-4727issn
1365-2710journal_volume
41pub_type
杂志文章abstract::A hypertensive crisis can be caused by many factors. Frequently, the mechanism involved is complex and highly variable among patients. Without drug therapy, this condition is associated with very high mortality and morbidity. There are a number of oral and intravenous hypotensive agents available, which can effectivel...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2710.1994.tb00669.x
更新日期:1994-06-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Despite recommendations to avoid fluoroquinolones (FQs) as a first-line treatment for uncomplicated cystitis, recent data suggest that FQs remain widely prescribed. Therefore, the objectives of this study were to evaluate the appropriateness of empiric FQ use compared to nitrofurantoin for u...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/jcpt.13099
更新日期:2020-06-01 00:00:00
abstract::Isradipine is a potent dihydropyridine calcium channel blocker. It is highly selective for vascular smooth muscle, with very few negative inotropic or chronotropic effects. It may have minor depressant effects on the sinoatrial node, hence reducing the incidence of reflex tachycardia. The drug is extensively metaboliz...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 临床试验,杂志文章,评审
doi:10.1111/j.1365-2710.1991.tb00288.x
更新日期:1991-04-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Acute coronary syndrome (ACS) is a leading cause of death. Correct implementation of evidence-based guidelines should improve outcome. We conducted this study to determine to what extent management of ACS in a tertiary care medical ward in Sri Lanka adhered to current guidelines. STUDY METHOD...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2710.2009.01115.x
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVE:To compare the efficacy of 500 mg ornidazole vaginal ovules (VO) and vaginal tablets (VT) in the treatment of bacterial vaginosis. METHOD:Patients were allocated at random to one group of 50 subjects to be treated with a VO (500 mg) prepared in our laboratory and to a second group of 50 subjects to be treate...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2710.2003.00472.x
更新日期:2003-04-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Scabies is recognized as a neglected tropical disease responsible for a substantial health and economic burden, especially in resource-poor communities around the world. COMMENT:There are relatively few current treatment options for scabies, and they possess important limitations. The treat...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/jcpt.12631
更新日期:2017-12-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Alzheimer's disease (AD) is the most common cause of dementia among the elderly. The exact cause of the disease is not clearly known, and no existing therapies are able to prevent disease progression. Identification of the possible "impaired brain insulin signalling in AD" enriched the scope...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章,评审
doi:10.1111/jcpt.12808
更新日期:2019-06-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:One-third of patients with epilepsy are resistant to anti-epileptic drugs (AEDs). Drug-resistant epilepsy is believed to be multifactorial involving both genetic and non-genetic factors. Genetic variations in the ABCB1 gene encoding the drug efflux transporter, p-glycoprotein (p-gp), may inf...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/jcpt.12263
更新日期:2015-06-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:5-Azacitidine (AZA) is an agent widely used to treat myelodysplastic syndrome (MDS). CASE DESCRIPTION:We herein report an 83-year-old woman diagnosed with MDS who was treated with AZA. She tolerated the first cycle of AZA; however, severe adverse events involving haemorrhagic enteritis with...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type:
doi:10.1111/jcpt.13146
更新日期:2020-08-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Two NS3/4A protease inhibitors (PIs), telaprevir and boceprevir, were recently approved in the United States. The primary objective was to compare the efficacy and safety of triple therapies including either PI to dual therapy in patients with chronic hepatitis C genotype 1; the secondary ob...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章,meta分析,评审
doi:10.1111/jcpt.12106
更新日期:2014-02-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Upper respiratory tract infections (URTI) frequently cause exacerbations of chronic-obstructive pulmonary disease (COPD). Stimulation of the innate immune system may provide an early defence against such infections. The objective of this study was to determine whether Echinacea purpurea (EP)...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1365-2710.2010.01212.x
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVE:To compare aminoglycoside pharmacokinetics in African-Americans with normal renal function with published adult population values. DESIGN:An Institutional Review Board approved concurrent study. SETTING:The study was conducted at Howard University Hospital, Washington DC. SUBJECTS:All subjects had serum cr...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 临床试验,杂志文章
doi:10.1046/j.1365-2710.1998.00130.x
更新日期:1998-06-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Imatinib mesylate (IM) is the first-line therapy for unresectable or metastatic gastrointestinal stromal tumours (GISTs). Here, we report a case of successful progressive dose optimization by therapeutic drug monitoring (TDM) for a patient with GISTs who developed IM-associated serious cutan...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type:
doi:10.1111/jcpt.13201
更新日期:2020-08-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Midazolam (MDZ) is commonly used for sedating critically ill patients. The daily dose required for adequate sedation increases in increments over 100 h after administration. The objectives of this study were to characterize the MDZ pharmacokinetics in critically ill patients and to describe ...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/jcpt.12395
更新日期:2016-08-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Based on spontaneous reports from Spain, it is claimed that the British, Irish and Scandinavians are at a greater risk of dipyrone-induced agranulocytosis. This report examines the evidence. COMMENT:Although interethnic differences in drug response are well known, there are no reliable epid...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/jcpt.12768
更新日期:2019-02-01 00:00:00
abstract::Parenterals, sterile preparations intended to be injected in man or animal, should be free from pyrogenic substances which are able to raise the thermostatic setting in the hypothalamus. This article gives an up-to-date review of the principal detection and quantification methods for these agents, with special attenti...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2710.1987.tb00531.x
更新日期:1987-08-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Lemierre's syndrome is often misdiagnosed as a common cold or viral infection. Fusobacterium necrophorum is the most common causative organism. The recommended treatment regimen is 6 weeks of a beta-lactam antibiotic along with metronidazole. CASE DESCRIPTION:We present two cases of Lemierr...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type:
doi:10.1111/jcpt.12774
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:To evaluate if once-daily dose (ODD) regimens of tobramycin attain pharmacodynamic goals using individualized pharmacokinetic monitoring of critically ill patients with creatinine clearance (Clcr) over 60 mL/min. METHODS:Fifty-one adult critically ill patients treated with intravenous tobramycin with ODD wer...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2710.2003.00539.x
更新日期:2004-02-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:This study aimed to elucidate the pharmacokinetics of erlotinib in Japanese patients with advanced non-small cell lung cancer (NSCLC) and to investigate the relationship between erlotinib exposure and the occurrence of interstitial lung disease (ILD)-like events. METHODS:Population pharmaco...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/jcpt.12232
更新日期:2015-04-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Although the risk of major bleeding with non-vitamin K antagonist oral anticoagulant (NOAC) is low, life-threatening bleeding can occur. CASE SUMMARY:We report a case of an 81-year-old female with deep vein thrombosis who developed bilateral spontaneous haemothorax and haemopericardium afte...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type:
doi:10.1111/jcpt.13116
更新日期:2020-10-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Recent reviews have shown that pharmacist-provided medication review in the elderly can improve clinical outcomes and reduce medication discrepancies compared with usual care. However, none determined whether these translate to improved humanistic and economic outcomes. This review sought to...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章,meta分析,评审
doi:10.1111/jcpt.12453
更新日期:2016-12-01 00:00:00
abstract::Antimicrobials are frequently used to prevent infections. Principles of prophylaxis, and antimicrobial prophylaxis in surgery, tuberculosis, acquired immunodeficiency syndrome, influenza A, traveller's diarrhoea, malaria, recurrent otitis media, Haemophilus influenzae type b infection, pertussis, rheumatic fever, and ...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2710.1996.tb01147.x
更新日期:1996-08-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Moxifloxacin is a new fluorquinolone with broad-spectrum activity. It is suitable for treating peritonitis in peritoneal dialysis (PD) patients. The objective of this study was to test stability of moxifloxacin in PD solutions stored at different temperatures. METHODS:Dialysis solution bags we...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2710.2006.00758.x
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:The use of extemporaneously prepared admixtures of drugs must be supported by documentation of their chemical stability. OBJECTIVE:To assess the physical compatibility and the chemical stability of nefopam hydrochloride, a centrally acting non-opioid analgesic, when admixed with selected proton pump inhibit...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2710.2008.00971.x
更新日期:2009-02-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Glucocorticoid-induced diabetes mellitus (GIDM) increases the risk of diabetes mellitus (DM)-related complications but is generally difficult to detect in clinical settings. The criteria for diagnosing GIDM have not been established. Recently, medical information databases (MIDs) have been u...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/jcpt.12499
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVES:To highlight therapeutic controversies, and present a critical review of the most recent evidence on the management of heparin-induced thrombocytopenia (HIT). DATA SOURCES:A MEDLINE search from October 1996 until October 2006 was carried out. Pertinent literature was identified and other references identifi...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2710.2007.00865.x
更新日期:2007-12-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVES:Different population pharmacokinetics (PPK) models of tacrolimus have been established in various populations. However, the tacrolimus PPK model in paediatric systemic lupus erythematosus (PSLE) is still undefined. This study aimed to establish the tacrolimus PPK model in Chinese PSLE. MET...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/jcpt.12707
更新日期:2018-08-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:The most appropriate sedative agent for conscious sedation in minor hysteroscopic surgeries is still unclear. Dexmedetomidine a sedative and analgesic agent, may be appropriate for outpatient procedures. The aim of our study was to compare the sedative, analgesic and hemodynamic effects of d...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章,随机对照试验
doi:10.1111/jcpt.12793
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:The anti-craving drug, naltrexone, is used as a pharmacotherapeutic adjunct in the treatment of alcohol dependence. In addictive disorders, compliance issues remain central. There are limited data on compliance with naltrexone treatment regimens within formalized rehabilitation programs and even less data th...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1046/j.1365-2710.2001.00326.x
更新日期:2001-02-01 00:00:00
abstract:OBJECTIVE:To describe sore throat management by primary care physicians in Poland. METHODS:We sent questionnaires to all primary care doctors in Podlaskie voievodship (north-eastern Poland) with clinical vignettes depicting patients with symptoms of sore throat. The probability of bacterial (streptococcal) infection w...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2710.2007.00894.x
更新日期:2008-04-01 00:00:00