Resumen de Idoneidad de la dosificación inicial de vancomicina en el paciente geriátrico
Javier Sánchez-Rubio Ferrández, Ana Ontañón Nasarre, Nuria Ibáñez Heras, Ainhoa Aranguren Oyarzábal, Esther Ramírez Herráiz
Objective: To determine initial vancomycin dosage adequancy for geriatric patients and to evaluate the posologic modifications proposed by the Pharmacy Department. Method: From the Pharmacy Department pharmacokinetic files there were selected those patients older than seventy years of age under treatment with vancomycin monitored during the year 2004. Minimal plasmatic concentrations (Cmin) of vancomycin were found in those patients after the third dosage. The doses were adjusted using Bayesian estimation assuming a two-tiered model with the help of the PKS software application. Results: Out of the 22 patients included, only two (9%) were found within the desired range (C min = 5-10 mcg/ml), while the rest were found to be overdosed (from 10.93 to 43.81 mcg/ml). After a first posologic adjustment, a second determination was carried out in 12 of the patients, from whom 42% were within the desired range (Cmin from 6.6 to 13.77 mcg/ml). Conclusions: The initial overdosing of vancomycin in the geriatric population constitutes a potential problem. Vancomycin concentrations monitoring by the Pharmacy Department allows achieve more extent of concentrations within the therapeutic range and could prevent the possible effects resulting from overdosing
