%0 Journal Article
%T The Effect of Hypoalbuminemia on the Therapeutic Concentration and Dosage of Vancomycin in Critically Ill Septic Patients in Low
%A Branislava Miljkovic
%A Danica Momcicevic
%A Momir Mikov
%A Pedja Kovacevic
%A Sasa Dragic
%A Svjetlana Stojisavljevic Satara
%A Tijana Kovacevic
%J Dose
%@ 1559-3258
%D 2019
%R 10.1177/1559325819850419
%X To determine whether severe hypoalbuminemia (<25 mg/L) has a significant effect on serum levels of vancomycin and whether it can effect vancomycin dosage regimen and the loading dose administration. Prospective, cohort, and a single-center study included 61 patients whose vancomycin serum levels were measured in steady state. Vancomycin trough levels (C min) that were in the range 15 to 20 ¦Ìg/mL were considered therapeutic and trough levels higher than 15 ¦Ìg/mL were considered potentially nephrotoxic. In the group of patients with severe hypoalbuminemia, C min was significantly higher compared to the those with nonsevere hypoalbuminemia (>25 mg/L; 23.04 [19.14] vs 13.28 [11.28], P = .01). In the group of patients who received the vancomycin loading dose of 2 g, C min was significantly higher in patients with severe hypoalbuminemia compared to the patients with nonsevere hypoalbuminemia (34.52 [25.93] vs 15.37 [10.48], P = .04). In critically ill septic patients with severe hypoalbuminemia, there is a high probability that the loading dose of vancomycin is not necessary since it is associated with potentially toxic vancomycin C min, while in the patients with nonsevere hypoalbuminemia the loading dose may be necessary to achieving therapeutic C min
%K severe hypoalbuminemia
%K vancomycin
%K therapeutic drug monitoring
%K sepsis
%K critical illness
%U https://journals.sagepub.com/doi/full/10.1177/1559325819850419