Pharmacokinetics of vancomycin in patients with various degrees of renal function

Antimicrob Agents Chemother. 1984 Apr;25(4):433-7. doi: 10.1128/aac.25.4.433.

Abstract

The pharmacokinetics of vancomycin were characterized in 56 patients with different degrees of renal function after an intravenous dose of 18.4 +/- 4.7 mg kg-1 (mean +/- standard deviation). Seven subjects had a creatinine clearance (CLCR) of greater than 60 ml min-1 (group I), 13 had a CLCR of 10 to 60 ml min-1 (group II), and 36 had a CLCR of less than 10 ml min-1 (group III). Serial serum samples (range, 3 to 8) were collected during the 168 h after drug administration. The serum concentration-time profile in all patients demonstrated monoexponential decay. The mean half-lives were 9.1, 32.3, and 146.7 h in groups I, II, and III, respectively. A significant decline in serum clearance (CLS) was also noted (62.7 to 28.3 to 4.87 ml min-1 in groups I, II, and III, respectively). The steady-state volume of distribution varied from 0.72 to 0.90 liter kg-1. There was no significant relationship between the steady-state volume of distribution and CLCR. The observed relationship between CLS and CLCR (CLS = 3.66 + 0.689 CLCR; r = 0.8807) can be utilized to devise dosage schedules for patients with any degree of renal impairment. This relationship was utilized to develop a nomogram for initial and maintenance dosing of vancomycin.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Creatinine / blood
  • Female
  • Half-Life
  • Humans
  • Kidney Diseases / metabolism*
  • Kinetics
  • Male
  • Middle Aged
  • Vancomycin / blood
  • Vancomycin / metabolism*

Substances

  • Vancomycin
  • Creatinine