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Evaluation of a protocol for vancomycin administration in critically patients with and without kidney dysfunction

Overview of attention for article published in BMC Anesthesiology, June 2015
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Title
Evaluation of a protocol for vancomycin administration in critically patients with and without kidney dysfunction
Published in
BMC Anesthesiology, June 2015
DOI 10.1186/s12871-015-0065-1
Pubmed ID
Authors

Savino Spadaro, Angela Berselli, Alberto Fogagnolo, Maurizia Capuzzo, Riccardo Ragazzi, Elisabetta Marangoni, Sara Bertacchini, Carlo Alberto Volta

Abstract

Administration of vancomycin in critically ill patients needs close regulation. While subtherapeutical vancomycin serum concentration (VSC) is associated with increased mortality, accumulation is responsible for nephrotoxicity. Our study aimed to estimate the efficacy of a vancomycin-dosing protocol in reaching appropriate serum concentration in patients with and without kidney dysfunction. This was a retrospective study in critically ill patients treated with continuous infusion of vancomycin. Patients with creatinine clearance >50 ml/min (Group A) were compared to those with creatinine clearance ≤50 ml/min (Group B). 348 patients were enrolled (210 in Group A, 138 in Group B). At first determination, patients with kidney dysfunction (Group B) had a statistically higher percentage of vancomycin in target range, while the percentage of patients with a VSC under the range was almost equal. These percentages differed at the subsequent measurements. The number of patients with low vancomycin concentration progressively decreased, except in those with augmented renal clearance; the percentage of patients with VSC over 30 mg/L was about 28 %, irrespective of the presence or absence of kidney dysfunction. Patients who reached a subtherapeutic level at the first VSC measurement had a significant correlation with in-hospital mortality. Our protocol seems to allow a rapid achievement of a target VSC particularly in patients with kidney dysfunction. In order to avoid subtherapeutical VSC, our algorithm should be implemented by the estimation of the presence of an augmented renal clearance.

Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 50 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 50 100%

Demographic breakdown

Readers by professional status Count As %
Other 7 14%
Student > Bachelor 7 14%
Student > Ph. D. Student 6 12%
Student > Postgraduate 5 10%
Student > Master 5 10%
Other 10 20%
Unknown 10 20%
Readers by discipline Count As %
Medicine and Dentistry 20 40%
Pharmacology, Toxicology and Pharmaceutical Science 14 28%
Biochemistry, Genetics and Molecular Biology 2 4%
Nursing and Health Professions 1 2%
Psychology 1 2%
Other 1 2%
Unknown 11 22%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 26 June 2015.
All research outputs
#20,281,599
of 22,815,414 outputs
Outputs from BMC Anesthesiology
#1,174
of 1,496 outputs
Outputs of similar age
#219,428
of 263,249 outputs
Outputs of similar age from BMC Anesthesiology
#18
of 23 outputs
Altmetric has tracked 22,815,414 research outputs across all sources so far. This one is in the 1st percentile – i.e., 1% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,496 research outputs from this source. They receive a mean Attention Score of 3.1. This one is in the 1st percentile – i.e., 1% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 263,249 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 23 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.