Articles: vancomycin-administration-dosage.
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J Bone Joint Surg Am · Jan 2014
Intrawound vancomycin powder eradicates surgical wound contamination: an in vivo rabbit study.
Surgical site infection remains a complication of spine surgery despite routine use of prophylactic antibiotics. Retrospective clinical studies of intrawound vancomycin use have documented a decreased prevalence of surgical site infection after spine surgery. The purpose of the present study was to assess the efficacy of intrawound vancomycin powder in terms of eradicating a known bacterial surgical site contamination in a rabbit spine surgery model. ⋯ This animal study supports the findings in prior clinical reports that intrawound vancomycin powder helps reduce the risk of surgical site infections.
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The indications for vancomycin prophylaxis to prevent Methicillin-resistant Staphylococcus aureus (MRSA) surgical site infections are increasing. The recommended dose of vancomycin has traditionally been 1 gram intravenous. However, the increasing prevalence of obesity in our population coupled with increasing resistance of MRSA to vancomycin has resulted in recent recommendations for weight-based dosing of vancomycin at 15 mg/kg. We hypothesize that the standard one gram dose of vancomycin is inadequate to meet the recently recommended dosage of 15 mg/kg. ⋯ In settings such as hospitals, where the risk for resistant bacteria, especially MRSA, is high, it is becoming increasingly important to accurately dose patients who require vancomycin. In order to avoid incorrect dosing of vancomycin health care providers must use weight-based dosing.
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To compare the likelihood of alternative vancomycin dosing strategies based on weight, height, or body surface area (BSA) in achieving isometric vancomycin area under the serum concentration-time curve (AUC) values across the body size distribution of children and young adults. ⋯ BSA-based dosing is more likely than weight-based (mg/kg) dosing of vancomycin to achieve isometric AUC24 values across the body size distribution of children and young adults. Pharmacokinetic studies that compare these two vancomycin dosing strategies in children are clearly needed to validate these findings.
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Eur J Orthop Surg Tr · Nov 2013
Review Case ReportsThe successful use of vancomycin-impregnated cement beads in a patient with vancomycin systemic toxicity: a case report with review of literature.
We report the use of vancomycin laden antibiotic cement beads in a patient with calcaneal osteomyelitis who had prior acute kidney injury (AKI). The patient experienced non-oliguric renal failure after exposure to intravenous vancomycin and recovered well after antibiotic discontinuation and adequate hydration. We are not aware of any similar case report where vancomycin laden antibiotic cement has been used in a patient with AKI to vancomycin.