Therapeutic drug monitoring of vancomycin in patients with infectious complications in traumatology and orthopedics

Abstract

Objective. The purpose of this study was to study the frequency of achievement of target values of vancomycin residual concentration (RC) and to identify the factors influencing this indicator. Materials and Methods. A retrospective observational study of vancomycin RC was performed in 471 patients who received vancomycin infusions in the department of purulent surgery of the RSRI of TO named after R.R. Vreden about capillary instillation after major orthopedic operations over the period from 01.01.2014 to 05.31.2016. Results. The target RC values on the third day of vancomycin administration reached 12.1% of patients (76.2% below target RC), after correction of the dosing regimen, the target RC was achieved in 20.3% of patients (56.9% below target RC). Multivariate analysis revealed a connection between RC and age (an increase in RC in age patients) and sex (a higher RC in women). In most cases, the prescribed doses of vancomycin corresponded to the recommended, however, the target RC levels of vancomycin were achieved only in a small proportion of patients. Conclusions. At the same time, the lowest frequency of reaching target concentrations was observed in young patients. The study proposed a multifactor model of vancomycin RC, on the basis of which it is possible to carry out the best correction of dosing taking into account the factors of age and sex.