The Most Appropriate Parameter Correlates With Clinical Effectiveness of Vancomycin: Trough Drug Concentration or Area Under Curve (AUC)/Minimum Inhibitory Concentration (MIC)?

September 2, 2014 updated by: National Taiwan University Hospital
The purpose of this study is to evaluate which is the most appropriate parameter correlates with clinical effectiveness of vancomycin: trough drug level or AUC/MIC.

Study Overview

Status

Completed

Conditions

Detailed Description

Several studies have shown AUC/MIC to be the better pharmacokinetic-pharmacodynamic parameter for clinical effectiveness of vancomycin. However, the 2009 consensus guideline for vancomycin therapeutic monitoring continued to recommend trough serum concentration monitoring in the clinical setting. In 2011, Patel et al showed that highly difference between AUC(72-96h) and Cmin(96h). Different dosing and creatinine clearance may reach the same trough drug level with different AUC. The investigators wonder whether trough drug level can serve as a substitute marker for AUC and as a parameter for vancomycin therapeutic monitoring.

In this study, the investigators will calculate AUC/MIC of vancomycin with published formula, analyze its correlation with patient's clinical outcome and compare that with trough drug level.

Study Type

Observational

Enrollment (Actual)

123

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Taiwan
      • Taipei, Taiwan
        • National Taiwan University Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

20 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

Inpatients of National Taiwan University Hospital. During the period of 2001/1/1 to 2013/12/31, age above or equal to 20 year-old adult with positive methicillin-resistant Staphylococcus aureus blood culture who receiving vancomycin therapy with therapeutic monitoring.

Description

Inclusion Criteria:

  • Inpatients of National Taiwan University Hospital
  • Age above or equal to 20 years old
  • Positive methicillin-resistant Staphylococcus aureus blood culture
  • Receiving vancomycin therapy for definitive use
  • Undergoing therapeutic drug monitoring (had serum vancomycin concentration level)

Exclusion Criteria:

  • Age below 20 years old
  • Without details of vancomycin dose and frequency
  • Vancomycin treatment shorter than 72 hours
  • Without renal function data (serum creatinine level, creatinine clearance)
  • Without infection-related clinical outcomes (lab data such as white blood cell count , seg, C reactive protein , body temperature records)
  • Receiving renal replacement therapy
  • Therapeutic drug monitoring before reaching steady state
  • With abnormal and undefined serum concentration

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
30-day mortality
Time Frame: Day 30 after index date (the date of positive methicillin-resistant Staphylococcus aureus blood culture)
Day 30 after index date (the date of positive methicillin-resistant Staphylococcus aureus blood culture)

Secondary Outcome Measures

Outcome Measure
Time Frame
90-day mortality
Time Frame: Day 90 after index date (the date of positive methicillin-resistant Staphylococcus aureus blood culture)
Day 90 after index date (the date of positive methicillin-resistant Staphylococcus aureus blood culture)
In-hospital mortality
Time Frame: Discharge day
Discharge day

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

National Taiwan University Hospital

Investigators

  • Principal Investigator: Li-Jiuan Shen, National Taiwan University Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

November 1, 2013

Primary Completion (Actual)

June 1, 2014

Study Completion (Actual)

June 1, 2014

Study Registration Dates

First Submitted

November 10, 2013

First Submitted That Met QC Criteria

November 26, 2013

First Posted (Estimate)

November 27, 2013

Study Record Updates

Last Update Posted (Estimate)

September 4, 2014

Last Update Submitted That Met QC Criteria

September 2, 2014

Last Verified

September 1, 2014

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 201310037RINA

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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