Study on Initial Dosage Setting of Vancomycin Injection.

To elucidate the current status of the dosage regimen of vancomycin, we reviewed its therapeutic drug monitoring (TDM) data obtained from 99 patients undergoing vancomycin treatment at the Chugoku Rousai Hospital. The plasma concentrations of vancomycin at one dosage under 750 mg deviated from its therapeutic ranges (the level at one hour after the end of infusion: 25-40μg/mL, trough level:≤10 μg/mL). Therefore, the dosing interval at a uniform dosage of 1000 mg was calculated from a vancomycin nomogram reported by Moellering et al., and the utility of the dosing interval at the uniform dosage of 1000 mg combined with a creatinine clearance nomogram reported by Nielsen et al. was examined. As a result, the plasma levels of 66 percent of the subjects were controlled within the accepted therapeutic ranges in the early stage. Accordingly, the nomogram of vancomycin prepared as an indication in the early stage in our hospital was thus concluded to be clinically acceptable.