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Table 1 Patient Characteristics (N = 103)

From: The impact of vancomycin trough concentrations on outcomes in non-deep seated infections: a retrospective cohort study

 

Low Trough (N = 48)

High Trough

(N = 55)

Odds Ratio

95% Confidence Interval

p-value

Gender (Male)

27 (56%)

28 (51%)

1.24

0.57–2.70

0.69

Age on Admission (Years), mean ± SD (Range)

59 ± 19 (21–91)

67 ± 21 (19–96)

  

0.06

Hospital Location at Vancomycin Initiation (Ward)

38 (79%)

44 (80%)

0.95

0.36–2.48

> 0.99

Length of Stay at the time of Vancomycin Initiation (Days),mediana(Range)

2(0–70)

2(0–187)

  

0.89

Any Comorbidityb

19 (40%)

25 (45%)

0.79

0.36–1.72

0.56

 • Congestive Heart Failure

3 (6%)

8 (15%)

0.39

0.098–1.57

0.21

 • Chronic Obstructive Pulmonary Disease

2 (4%)

7 (13%)

0.30

0.06–1.51

0.17

 • Diabetes Mellitus

7 (15%)

10 (18%)

0.77

0.27–2.21

0.79

 • Immunosuppression due to disease or drugc

8 (17%)

6 (11%)

1.63

0.52–5.10

0.57

APACHE IId, mean ± SD (ICU patients)

17 ± 6 (11–25)

23 ± 11 (6–41)

  

0.32

Critically Ill Ward Patients

(Pitt Bacteremia Score ≥ 4)

1 (2%)

4 (7%)

0.27

0.03–2.52

0.37

Baseline Creatinine (mmol/L)

77 ± 32 (23–185)

83 ± 45 (18–254)

  

0.42

Use of Concomitant Nephrotoxinse

35 (73%)

36 (65%)

1.42

0.61–3.31

0.52

 • # of Concomitant Nephrotoxinsa (median)

1 (0–3)

1 (0–4)

  

0.49

Use of Concomitant Antibioticsf

21 (44%)

17 (31%)

1.74

0.78–3.90

0.22

 • Same Indication as Vancomycing

18 (86%)

14 (82%)

1.29

0.22–7.37

> 0.99

Included Infections

     

 • All SSTIs

31 (65%)

32 (58%)

1.31

0.59–2.91

0.55

  o Cellulitis

25 (52%)

22 (40%)

1.63

0.75–3.57

0.24

  o Wound/Surgical Site Infection

6 (12%)

10 (18%)

0.64

0.21–1.92

0.59

 • All UTIs

11 (23%)

7 (13%)

2.04

0.72–5.77

0.20

  o MRSA UTI

2 (4%)

1 (2%)

2.35

0.21–26.75

0.60

  o Enteroccocal UTI

9 (19%)

6 (11%)

1.88

0.62–5.75

0.28

 • All Bacteremias

4 (8%)

10 (18%)

0.41

0.12–1.40

0.16

  o CNST Bacteremiah

3 (6%)

8 (15%)

0.39

0.10–1.57

0.21

 • Any Positive CNST in Blood

5 (10%)

14 (25%)

0.34

0.11–1.03

0.07

Microbiology

     

 • Patients With Positive Non-Screening Cultures for Resistant Gram positive isolatesi

10 (21%)

22 (40%)

0.39

0.16–0.95

0.054

  o Patients with MRSA Clinical Culture

2 (4%)

5 (9%)

0.43

0.08–2.35

0.44

  o Patients with CNST Clinical Culture

8 (17%)

17 (31%)

0.45

0.17–1.16

0.11

 • MRSA-colonized Patients

2 (4%)

8 (15%)

0.26

0.05–1.27

0.10

 • VRE-colonized Patients

1 (2%)

0

3.50

0.14–88.15

0.47

  1. ACEI Angiotensin converting enzyme inhibitor, AIDS Acquired immune deficiency syndrome, APACHE Acute Physiology and Chronic Health Evaluation, ARB Angiotensin II receptor blocker, ASA Acetylsalicylic acid, HCTZ Hydrochlorothiazide, CNST Coagulase-negative Staphylococci, HIV Human immunodeficiency virus, ICU Intensive Care Unit, NSAID Nonsteroidal anti-inflammatory drug, PPI Proton pump inhibitor, SD Standard deviation, SSTI Skin and soft tissue infection, TNF-α Tumor necrosis factor alpha, UTI Urinary tract infection, VRE Vancomycin-resistant Enterococci
  2. aFor non-normally distributed data, the median with range was reported
  3. bPatients may have had more than 1 comorbidity, thus totals for specific comorbidities sum to a value greater than the number of patients with any comorbidity
  4. cDisease: HIV/AIDS, asplenia, hematological malignancies, transplantation. Drug: Corticosteroids (prednisone > 5 mg/day, chemotherapy, TNF-α inhibitors, transplant medications)
  5. dArterial blood gases were not available for all ICU patients and APACHE II scoring could not be completed for these patients; reported values are based on 6 patients in low trough cohort and 7 patients in high trough cohort
  6. eNSAIDs, ACEIs, ARBs, cyclosporine, tacrolimus, acyclovir, aminoglycosides, amphotericin, colistin, indinavir, adefovir, cidofovir, tenofovir, chemotherapy (e.g. carmustine, semustine, cisplatin, methotrexate, mitomycin), foscarnet, contrast dye, zoledronate, loop diuretics, HCTZ, triamterene, hydralazine, interferons, PPIs, sulfonamides, lithium, aristocholic acid, acetaminophen at > 1 g/day for > 2 years, ASA at > 1 g/day for > 2 years)
  7. fConcomitant antibiotic defined as: ≥48 h overlap with vancomycin and administered for ≥48 h
  8. gDenominator for percentage calculations is the number of patients (n) on concomitant antibiotics (i.e. low trough n = 18; high trough n = 14)
  9. hDefined as ≥2 positive blood cultures on the same day
  10. iMethicillin Resistant Staphylococcus aureus, Coagulase-negative Staphylococci, or Vancomycin Resistant Enterococci cultured from 3 days prior to initiation or during vancomycin course of therapy and includes a single positive culture for CNST
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BMC Pharmacology and Toxicology

ISSN: 2050-6511

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