Japanese Journal of Infection Prevention and Control
Online ISSN : 1883-2407
Print ISSN : 1882-532X
ISSN-L : 1882-532X
Original Article
Evaluation of Pharmaceutical Intervention for Achieving Appropriate and Effective Use of Anti-MRSA Agents
Noriyuki ISHIHARANobuhiro NISHIMURATakayuki SUYAMAAkira YAMAMOTOHiroki TAMAKITomochika UEMURATakeshi ISOBEFumiko INAGAKIKikuo IWAMOTOKohji NAORA
Author information
JOURNAL FREE ACCESS

2010 Volume 25 Issue 1 Pages 15-21

Details
Abstract

  The glycopeptide antibiotics vancomycin (VCM) and teicoplanin (TEIC), and the aminoglycoside antibiotic arbekacin (ABK) are considered to be effective for the treatment of methicillin-resistant Staphylococcus aureus (MRSA). Since these anti-MRSA drugs have narrow therapeutic indexes, therapeutic drug monitoring (TDM) is helpful for the optimal management of anti-MRSA chemotherapy based on pharmacokinetics-pharmacodynamics (PK-PD) theory. Thus, we began PK-PD theory-based interventions with TDM on anti-MRSA drug use from 2005 in our hospital. We analyzed dosing methods and outcomes of 157 patients treated with anti-MRSA drugs in 2004 (without intervention), and in 2005 and 2006 (with intervention).
  After the beginning of the pharmaceutical interventions, the proportion of patients receiving TDM-based treatment (TDM patients) was increased (2% in 2004 and 55% in 2006), and was associated with reduced mean dosing periods of VCM, increased execution rate of loading dose of TEIC, and prolonged dosing interval without changes in the daily dose of ABK. Among the patients treated with anti-MRSA drugs, the clinical effectiveness in TDM patients was 93.0%, which was higher than 68.4% in non-TDM patients. These results suggest that pharmaceutical intervention based on PK-PD theory with TDM could promote optimization of the dosing regimen of anti-MRSA drugs, leading to more effective anti-MRSA chemotherapy.

Content from these authors
© 2010 Japanese Society for Infection Prevention and Control
Previous article Next article
feedback
Top