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논문 기본 정보

자료유형
학술저널
저자정보
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한국임상약학회 한국임상약학회지 한국임상약학회지 제19권 제2호
발행연도
2009.1
수록면
120 - 130 (11page)

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The objective of this study was to analyze and to improve therapeutic drug monitoring(TDM) service of vancomycin in a local hospital. Patients with TDM service between September 2005 and December 2008 were included and the data were collected for vancomycin use and components of TDM. During that period, 421 cases of TDM service of vancomycin in 236 patients were retrospectively reviewed. The first dosages of vancomycin were appropriate in 135(57.2%) patients and administration of vancomycin was discontinued in 126(53.4%) patients due to therapeutic failure or adverse drug reaction. MRSA was identified in 191(80.9%) patients and 135(70.7%) samples for the identification were sputum. According to the TDM reports, 232(55.1%) serum samples were obtained at the steady-state conditions and 55.5% of the samples that were drawn before the steady-state was due to the physician's inappropriate knowledge about the steady-state. Based on the time of vancomycin administration, 35.8% of the samples were not obtained at the recommended sampling time. For the patients in general wards, the most common reason for the incorrect samples was routine serum sampling by the laboratory medicine phlebotomists between 6 and 8 a.m. except sunday. In contrast, samples drawn by nurses or physicians at inappropriate time were the most common reason for the incorrect samples with patients in the intensive care units. Physicians accepted 68.5% of the recommendations for vancomycin dosage and administration. In conclusion, TDM service of vancomycin needs to be improved in inappropriate sampling time and vancomycin dosage. For solving these problems, current team made of TDM pharmacists and physicians of laboratory medicine can be expanded to include a physician of infectious diseases, nurses and laboratory medicine phlebotomists as new members. Through the TDM service of vancomycin by the new team, we can settle the problems and make the guideline for the scientific controversies associated with therapeutic monitoring of vancomycin.
#vancomycin #therapeutic drug monitoring #TDM #sampling time

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참고문헌 (15)

참고문헌 신청
Anders I / 1997 / Pascual C.Vancomycin monitioing; one or two serum level? / Ther Drug Monit 19 : 614 ~ 619 google schola Begg EJ / 2001 / The Therapeutic monitoring of antimicrobial agents / Br J Clin Pharmacol 52 (1) : S35 ~ S43 google schola Chung Joowon / 2006 / unpublished data” Analysis of Therapeutic Drug Monitoring(TDM) of vancomycin in Critically Ill Patients with Pneumonia google schola Freeman CD / 1993 / Vancomycin therapeutic drug monitoring: is it neceaasry? / Ann Pharmacother 27 : 594 ~ 598 google schola Michael Rybak / 2009 / Therapeutic monitoring of vancomycin in adult patients: A consensus review of the American Society of Health-System Pharmacists, the Infectious Disease google schola

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