Feasibility of serum Cystatin C for predicting Vancomycin concentration in abdominal cancer patients with severe infectious disease

作者：Xiaowu Zhang, Donghao Wang · 年份：2019 · DOI：10.21203/rs.2.18049/v1 · 研究领域：Neutropenia and Cancer Infections、Chronic Kidney Disease and Diabetes、Urinary Tract Infections Management

Abstract Background: This study was designed to investigate the population pharmacokinetics and impact indicator of vancomycin in abdominal cancer patients complicated with severe infectious disease. Methods: A total of 78 patients abdominal cancer patients complicated with severe infectious disease were included. Vancomycin serum trough concentrations were measured using the fluorescence polarization immunoassay (FPIA) method. The patients were divided into early and delayed groups based on whether they achieve the target concentration. And clinical factors were compared between two groups.Results: The average initial therapeutic dose of vancomycin was 15.18±3.29 mg/kg (q12h). The research revealed that the abdominal cancer patients complicated with severe infectious disease had significantly lower initial vancomycin trough concentrations (median [IQR]: 6.90[5.28-11.20] mg/L). Multiple regression analysis revealed that Cys-C was the most important variable for vancomycin target trough achievement. The duration of mechanical ventilation in Early group was considerably shorter compared with group Delayed group (χ2=4.532; p < 0.05; Fig 1E). Propensity score weighting further confirmed that the duration of mechanical ventilation (χ2=6.607; p < 0.05; Fig 1F) and vasoactive agent (χ2=6.106; p < 0.05; Fig 1D) was considerably shorter compared with group Delayed group. Conclusions: The steady-state initial vancomycin trough concentration was significantly reduced in abdomi...