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Abstract
Objective: To evaluate the use of vancomycin in the treatment of infections in patients admitted to the Intensive Care Unit (ICU) and to verify the adequacy of the therapeutic range after monitoring. Methods: This is a retrospective, cross-sectional, single-center study, carried out in a highly complex hospital in the North Region, from January to June 2022. Patients under 18 years of age and using oral vancomycin and/or prophylactic. Results: A total of twenty patients were included, with a mean age of 48.8 ± 19.07 years. There was a predominance of males (55%), the main comorbidities were systemic arterial hypertension (SAH) (45%) and neoplasms. A total of 29 vancokinemias were performed, of which 58.6% obtained a subtherapeutic dose, on the other hand, in patients who died (40%), there was a preponderance of the toxic dose (50%). Microbiological tests were requested for 55% of the patients, and in the positive cultures, there was a predominance of Pseudomonas aeruginosa (33.4%). Conclusion: Vancokinemia is essential for safe pharmacotherapy and should be performed in critically ill patients, especially those admitted to the ICU, to prevent therapeutic failures. The joint action of the multidisciplinary team makes it possible to optimize antibiotic therapy and reduce the progress of bacterial resistance.
References
ANDRADE LB. O papel do farmacêutico no âmbito hospitalar. Instituto Nacional de Ensino Superior e Pesquisa, Centro de Capacitação Educação (CCE) em Farmácia Hospitalar e Clínica, 2015.
ARAÚJO RQ e ALMEIDA SM. Farmacêutico Intensivista, o diferencial, na UTI. Rev Pharmacia Brasileira. 2010; 12(78): 17-22.
BAIOCCO GG. Protocolo de Vancocinemia: os impactos sobre a segurança dos pacientes. Universidade Federal de Ciências da Saúde de Porto Alegre – UFCSPA. Programa de Pós-Graduação em Ciências da Saúde. Tese (doutorado). Orientadora: Profª Drª. Helena Maria Tannhauser Barros. Porto Alegre, RS. 2022.
BRAUN M e LINDEN R. Evaluation of initial dosing regimens of vancomycin used in the treatment of infections in patients into a trauma intensive care unit. Rev Bras Farm Hosp Serv Saude, 2022; 13(4): 0845.
CONSELHO FEDERAL DE FARMÁCIA (CFF) – Resolução nº 585 de 29 de agosto de 2013. Disponível em: https://www.cff.org.br/userfiles/file/resolucoes/585.pdf.
DINIZ AMM e SANTOS RMCS. Ocorrência de Escherichia coli e Klebsiella spp produtoras de ESBL em Hospital Universitário, na cidade de Manaus - AM. Revista de Epidemiologia e Controle de Infecção, Santa Cruz do Sul, 2019; 9(2).
DOMBROSKI V, et al. Monitoramento Terapêutico de Vancomicina em uma Unidade de Terapia Intensiva. Rev. Med. UFPR. 2015; 2(2): 67-73.
FAVARIN SS e CAMPONOGARA S. Perfil dos pacientes internados na Unidade de Terapia Intensiva adulto de um Hospital Universitário. Universidade Federal de Santa Maria. REUFSM. Rev. Enferm. UFSM, 2012; 2(2):320-329.
FEDERICO MP, et al. Notions of pharmacokinetic and pharmacodynamic parameters, and their use in medical practice. Universidade Estadual de Feira de Santana, Feira de Santana, BA, Brasil. Rev Soc Bras Clin Med, 2017; 15(3): 201-205.
FERNANDES LL. A importância do farmacêutico hospitalar juntamente com a equipe multidisciplinar na Unidade de Terapia Intensiva (UTI). Revista FAROL – Rolim de Moura – RO, 2019; 8(8): 5-21.
GAMBOA JS. Monitorização Farmacocinética da Vancomicina nos Serviços Farmacêuticos do CHUCB. Dissertação (Mestrado em Ciências Farmacêuticas) – Departamento de Ciências Médicas. Universidade Beira Interior, 2021; 3-16 p.
HAFFERNAN AJ, et al. Vancomycin population pharmacokinetics for adult patients with sepsis or septic shock: are current dosing regimens sufficient? Eur J Clin Pharmacol., 2019; 75(9): 1219-1226.
HECKLER AM e HAHN SR. Implementation of vancomycin therapeutic monitoring protocol in adults. Rev. Epidemiol. Controle Infecç. Santa Cruz do Sul, 2020; 10(3):263-269.
JEFFRES MN. The Whole Price of Vancomycin: Toxicities, Troughs, and Time. Drugs, 2017; 77(11): 1143–1154.
KISAT M, et al. Antibiotic Therapy in the Intensive Care Unit. Surgical Clinics of North America, 2022; 102(1): 159-167.
LINS AC, et al. Infecções Hospitalares em pacientes submetidos à Clipagem de Aneurisma internados na Unidade de Terapia Intensiva do Hospital Universitário Getúlio Vargas na Cidade de Manaus-AM. J Bras Neurocirurg, 2012; 23(4): 281-287.
MACÊDO AMA, et al. Análise de sobrevida de pacientes com pneumonia associada à ventilação mecânica invasiva. Rev Min Enferm., 2021; 25:e-1372.
MACÊDO GGC, et al. Characterization of vancomycin use, dosage and clinical indicators of critical neurosurgical and polytraumatized patients. Revista Eletrônica Acervo Saúde, 2022; 15(7): e10640.
MAGALHÃES ACAF, et al. Evaluation of the implementation of clinical pharmacy service in the Intensive Care Unit to contribute to patient safety. Rev Med Minas Gerais, 2016; 26(5): 16-22.
MALTA DC, et al. Avaliação da função renal na população adulta brasileira, segundo critérios laboratoriais da Pesquisa Nacional de Saúde. Rev Bras Epidemiol, 2019; 22(2): 2.
MEDELLÍN-GARIBAY SE, et al. Pharmacokinetics of vancomycin and dosing recommendations for trauma patients. Journal of Antimicrobial Chemothery, 2016; 71(2): 471–479.
MOTA FS, et al. Perfil e prevalência de resistência aos antimicrobianos de bactérias Gram-negativas isoladas de pacientes de uma unidade de terapia intensiva. RBAC, 2018; 50(3): 270-277.
OLIVEIRA MAM, et al. Comparação dos perfis inflamatório e trombótico de pacientes com COVID-19 em seus diferentes desfechos: alta hospitalar e óbito. Research, Society and Development, 2022; 11(2): e34311225990.
PARIS MC, et al. Epidemiological profile, and prognosis of traumatized patients hospitalized in an Intensive Care Unit. Universidade Estadual do Centro Oeste. Curitiba, PR – Brasil. Brazilian Journal of Development, 2021; 7(3): 28588-28603.
REINER GL, et al. Desfecho clínico e fatores associados ao óbito em pacientes com sepse internados em Unidade de Terapia Intensiva. AMB. Arq. Catarin Med, 2020; 49(1): 02-09.
RYBAK MJ, et al. Therapeutic monitoring of vancomycin for serious methicillin-resistant Staphylococcus aureus infections: A revised consensus guideline and review by the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the Society of Infectious Diseases Pharmacists. American Journal of Health-System Pharmacy, 2020; 77(11): 835–864.
SOCIEDADE BRASILERA DE FARMÁCIA HOSPITALAR (SBRAFH). Padrões Mínimos para Farmácia Hospitalar e Serviços de Saúde. 3ª Ed., São Paulo: Editora Atheneu, 2000. ISBN: 978-85-61645-00-7.
SOUZA ERS, et al. Perfil de crescimento de cepas multirresistentes em UTI´s de um hospital referência em doenças tropicais. Revista Feridas, 2022; 10(54).
SOUZA LG, et al. Farmácia clínica e vancocinemia: da monitorização terapêutica à mudança de conduta nas unidades de internação. Hospital Santa Casa de Maringá. RBFHSS. Rev. Bras Farm Hosp Serv Saude, 2021; 12(4): 6-18.
STEIN FC, et al. Prognostic factors in elderly patients admitted in the intensive care unit. Serviço de Terapia Intensiva do Hospital do Servidor Público Estadual “Francisco Morato de Oliveira” – HSPE-FMO – São Paulo (SP), Brasil. Rev Bras Ter Intensiva. 2009; 21(3):255-261.
ZAMONER W, et al. Vancomycin dosing, monitoring and toxicity: Critical review of the clinical practice. Clin Exp Pharmacol Physiol. 2019; 46(4): 292–301.
DOS SANTOS MA, et al. Enterococcus resistente à vancomicina (VRE): perfil geral. Revista JRG De Estudos Acadêmicos, 2021; 4(8): 127–139.
KOVACEVIC T, et al. Population phamacokinetic modelo f Vancomycin based on therapeutic drug monitoring data in critically ill septic patients. Journal of Critical Care, 2020; 55(1): 116-121.
YANG CY, et al. Differential effects of inappropriate empirical antibiotic therapy in adults with community-onset gram-positive and gram-negative aerobe bacteremias. Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan. Journal of Infection and Chemotherapy, 2020; 26(2): 222-229.