Wragge T M, Cooper B E
Hamot Medical Center, Erie, PA.
Ann Pharmacother. 1993 Nov;27(11):1346-8. doi: 10.1177/106002809302701107.
To investigate a correlation between the elimination rate constants (Ke) of aminoglycosides (AG) and vancomycin; to investigate the correlation between actual Ke and creatinine clearance (Clcr) for AG versus vancomycin; to investigate the calculated versus actual Ke for AG and vancomycin; and to investigate a correlation between volumes of distribution (Vd) between AG and vancomycin.
Retrospective data collection.
Patients in our institution who received AGs or vancomycin concomitantly or within six weeks of each other were identified retrospectively. Patient subpopulations were identified and analyzed collectively as well as individually. Steady-state serum concentrations of AG and vancomycin (more than four half-lives) were obtained and kinetic parameters (Ke, Vd) were calculated using first-order pharmacokinetic equations. Linear regression was used to determine correlation coefficients.
In the total population and all subpopulations, the correlation between Ke of AG and vancomycin was superior to the correlation between Ke and Clcr. The correlations (r2) between Ke for AG and vancomycin in the total, general medicine, oncology, and intensive care units (ICU) populations were 0.572, 0.878, 0.349, and 0.561, respectively. The correlations (r2) between Ke and Clcr for AG in the total, general medicine, oncology, and ICU populations were 0.235, 0.430, 0.005, and 0.238, respectively. The correlations (r2) between Ke and Clcr for vancomycin in the total, general medicine, oncology, and ICU populations were 0.300, 0.407, 0.055, and 0.309, respectively.
The correlation between Ke of AG and vancomycin may be beneficial for predicting Ke of vancomycin when AG concentrations have already been obtained or vice versa, and may give more accurate estimations of dosing intervals and require less time adjusting, ordering, and interpreting concentrations and dosages.
研究氨基糖苷类药物（AG）与万古霉素的消除速率常数（Ke）之间的相关性；研究AG与万古霉素实际Ke与肌酐清除率（Clcr）之间的相关性；研究AG和万古霉素的计算Ke与实际Ke；研究AG与万古霉素分布容积（Vd）之间的相关性。
回顾性数据收集。
回顾性确定我院同时或在彼此六周内接受AG或万古霉素治疗的患者。对患者亚组进行集体和个体识别与分析。获取AG和万古霉素的稳态血清浓度（超过四个半衰期），并使用一级药代动力学方程计算动力学参数（Ke、Vd）。采用线性回归确定相关系数。
在总体人群和所有亚组中，AG与万古霉素Ke之间的相关性优于Ke与Clcr之间的相关性。总体、普通内科、肿瘤和重症监护病房（ICU）人群中AG与万古霉素Ke之间的相关性（r2）分别为0.572、0.878、0.349和0.561。总体、普通内科、肿瘤和ICU人群中AG的Ke与Clcr之间的相关性（r2）分别为0.235、0.430、0.005和0.238。总体、普通内科、肿瘤和ICU人群中万古霉素的Ke与Clcr之间的相关性（r2）分别为0.300、0.407、0.055和0.309。
AG与万古霉素Ke之间的相关性可能有助于在已获得AG浓度时预测万古霉素的Ke，反之亦然，并且可以更准确地估计给药间隔，减少调整、订购以及解读浓度和剂量所需时间。
