2019 Volume 45 Issue 10 Pages 553-560
Bedridden patients are reported to have overestimated renal functions. The association between activity of daily living and vancomycin (VCM) trough concentration remains unclear. This retrospective study aimed to investigate the influence of trough VCM concentrations in non-elderly bedridden patients with an estimated glomerular filtration rate (eGFR) over 60 mL/min/1.73m2. Hospitalized patients from July 2015 to January 2019 were classified into the bedridden (n = 32) and mobile group (n = 67) based on activity of daily life according to the criteria of Ministry of Health, Labour and Welfare. The bedridden group was defined as patients having scores of B or C over 28 days. We compared VCM trough concentrations and distribution of VCM concentrations (< 10, 10 - 20, and > 20 μg/mL) between bedridden and mobile patients. We compared the VCM trough concentrations after adjusting the propensity scores (n = 32 in each group). The median of the first VCM trough concentration was significantly higher in the bedridden than in mobile patients both before (10.2 μg/mL vs 13.9 μg/mL, P = 0.012) and after (9.7 μg/mL vs 13.9 μg/mL, P = 0.014) propensity score adjustment. The distributions of VCM trough concentrations of < 10, 10 - 20, and > 20 μg/mL were 51％, 42％, and 8％ in the mobile patients and 28％, 44％, and 28％ in the bedridden patients, respectively (P = 0.011). In conclusion, the present study suggests that in non-elderly patients with eGFR over 60 mL/min/1.73m2, the first VCM trough concentrations were significantly higher in the bedridden than in mobile patients.
