Nakashima T, Koido K, Baba H, Otsuka R, Okinaka K, Sano T, Nishigaki R, Hashimoto H, Otsuka T, Esaki M, Terakado H
Pharmazie. 2018 Jul 1;73(7):422-424. doi: 10.1691/ph.2018.8427.
BACKGROUND/AIM: Dose adjustment of vancomycin (VCM) is important in improving clinical outcomes and avoiding adverse effects such as nephrotoxicity. Although pharmacist-managed VCM therapy has been reported to optimize treatment, there are no studies focused on pharmacist expertise to date. In this study, we compared the contribution of pharmacists trained for infectious diseases and general pharmacists to dose adjustment of VCM.
We retrospectively investigated VCM trough concentration after dose adjustment by both trained (n = 67) and general (without special training for infectious diseases; n = 85) pharmacists. We also compared the incidence of nephrotoxicity during VCM treatment in both groups.
The rate of achieving therapeutic VCM trough concentration (10-20 μg/mL) was higher in the trained group than in the control group (80.6 vs. 54.1%, p < 0.001). No significant differences in incidence of nephrotoxicity were observed between the two groups (p = 0.744). Trained pharmacists could contribute more successfully to the achievement of therapeutic VCM concentration ranges without increasing the risk of nephrotoxicity.
背景/目的：万古霉素（VCM）的剂量调整对于改善临床疗效以及避免诸如肾毒性等不良反应至关重要。尽管据报道由药剂师管理的VCM治疗可优化治疗，但迄今为止尚无专注于药剂师专业知识的研究。在本研究中，我们比较了接受过传染病培训的药剂师和普通药剂师对VCM剂量调整的贡献。
我们回顾性调查了经过培训的药剂师（n = 67）和普通药剂师（未接受传染病专项培训；n = 85）调整剂量后的VCM谷浓度。我们还比较了两组在VCM治疗期间肾毒性的发生率。
经过培训的组达到治疗性VCM谷浓度（10 - 20μg/mL）的比例高于对照组（80.6%对54.1%，p < 0.001）。两组之间肾毒性发生率未观察到显著差异（p = 0.744）。经过培训的药剂师能够更成功地促使达到治疗性VCM浓度范围，而不会增加肾毒性风险。
