DOI: https://doi.org/10.22263/2312-4156.2024.2.35
N.V. Belyavsky1, R.E. Yakubtsevich1, L.Z. Shchebet2, A.N. Bogdanovich2
The vancomycin use peculiarities in complex therapy for sepsis combined with the application of sorption methods of extracorporeal detoxification
1Grodno State Medical University, Grodno, Republic of Belarus
2Grodno University Clinic, Grodno, Republic of Belarus
Vestnik VGMU. 2024;23(2):35-40.
Abstract.
Objectives. To study the effect of extracorporeal hemosorption with the use of “Hemoproteazosorb” hemosorbent on the vancomycin levels in plasma of sepsis patients.
Material and methods. A total of 14 patients with sepsis of various etiology were selected, whose complex intensive treatment included antibacterial therapy with vancomycin and extracorporeal hemosorption using the hemosorbent “Hemoproteazosorb” (Republic of Belarus). For each patient, the AUC/MIC was calculated based on Bayesian statistics and patient’s data (the empirical value), as well as on the measurement of vancomycin plasma concentration (the actual value). The open source application VancoCalc was used for calculations.
Results. A decrease by 32.9% (p<0.005) in vancomycin concentration after hemosorption with “Hemoproteazosorb” was revealed. The empirical value of AUC/MIC, calculated without considering the effect of hemosorption, made up 472±173 μg*h/mL; the actual one was 302±98 μg*h/mL, which is significantly less than the recommended range of 400-600 μg*h/mL (p<0.004).
Conclusions. The data obtained by us indicate that the hemosorbent “Hemoproteazosorb” adsorbs vancomycin in clinically significant amounts. Careful monitoring of the plasma concentration of the drug is required, followed by the calculation of AUC/MIC and adjustment of vancomycin dose in patients with sepsis in whom hemosorption with the studied sorbent is indicated.
Keywords: vancomycin, sepsis, AUC, VancoCalc, hemoproteazosorb, hemosorption.
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Information about authors:
N.V. Belyavsky – lecturer of the Chair of Anesthesiology and Resuscitation, Grodno State Medical University, https://orcid.org/0000-0003-0452-8876
e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Nikolay V. Belyavsky;
R.E. Yakubtsevich – Doctor of Medical Sciences, professor, head of the Chair of Anesthesiology and Resuscitation, Grodno State Medical University, https://orcid.org/0000-0002-8699-8216
L.Z. Shchebet – anesthesiologist-resuscitator of the hemodialysis department with extracorporeal detoxification methods, Grodno University Clinic;
A.N. Bogdanovich – clinical laboratory diagnostics doctor, Grodno University Clinic.
