Cotogni P, Barbero C, Rinaldi M. Incidence and risk factors for potentially suboptimal serum concentrations of vancomycin during cardiac surgery. World J Cardiol 2018; 10(11): 234-241 [PMID: 30510640 DOI: 10.4330/wjc.v10.i11.234]
Corresponding Author of This Article
Paolo Cotogni, MD, MSc, Adjunct Professor, Doctor, Department of Anesthesia, Intensive Care and Emergency, Molinette Hospital, University of Turin, C.so Bramante, 88/90, Turin 10126, Italy. paolo.cotogni@unito.it
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 26, 2018 (publication date) through Mar 13, 2026
Times Cited of This Article
Times Cited (0)
Journal Information of This Article
Publication Name
World Journal of Cardiology
ISSN
1949-8462
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Cotogni P, Barbero C, Rinaldi M. Incidence and risk factors for potentially suboptimal serum concentrations of vancomycin during cardiac surgery. World J Cardiol 2018; 10(11): 234-241 [PMID: 30510640 DOI: 10.4330/wjc.v10.i11.234]
World J Cardiol. Nov 26, 2018; 10(11): 234-241 Published online Nov 26, 2018. doi: 10.4330/wjc.v10.i11.234
Incidence and risk factors for potentially suboptimal serum concentrations of vancomycin during cardiac surgery
Paolo Cotogni, Cristina Barbero, Mauro Rinaldi
Paolo Cotogni, Department of Anesthesia, Intensive Care and Emergency, Molinette Hospital, University of Turin, Turin 10126, Italy
Cristina Barbero, Mauro Rinaldi, Cardiovascular Surgery, Department of Surgical Sciences, Molinette Hospital, University of Turin, Turin 10126, Italy
Author contributions: Cotogni P designed the study and drafted the manuscript; Barbero C participated in the study design, carried out the study and helped to draft the manuscript; Rinaldi M participated in the study design and coordination and revised it critically for important intellectual content; all authors read and approved the final manuscript.
Supported bythe Public Health Program of Regione Piemonte (Italy), No. 2472/DA2001 (to Paolo Cotogni, in part).
Institutional review board statement: The study protocol was reviewed and approved by our Institutional Ethics Committee (Comitato Etico Interaziendale A.O.U. San Giovanni Battista di Torino - A.O.C.T.O. Maria Adelaide di Torino) (approval No. 0078553).
Informed consent statement: All patients provided written informed consent before their enrollment in the study.
Conflict-of-interest statement: All authors have no conflicts of interest to disclose.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement - checklist of items, and the manuscript was prepared and revised according to the guidelines of the STROBE Statement.
Corresponding author to: Paolo Cotogni, MD, MSc, Adjunct Professor, Doctor, Department of Anesthesia, Intensive Care and Emergency, Molinette Hospital, University of Turin, C.so Bramante, 88/90, Turin 10126, Italy. paolo.cotogni@unito.it
Telephone: +39-338-7018496 Fax: +39-11-5171634
Received: July 9, 2018 Peer-review started: July 10, 2018 First decision: August 2, 2018 Revised: September 2, 2018 Accepted: October 11, 2018 Article in press: October 11, 2018 Published online: November 26, 2018 Processing time: 140 Days and 3.6 Hours
ARTICLE HIGHLIGHTS
Research background
Based on evidence suggesting that Staphylococcus aureus exposure to low vancomycin concentrations can produce vancomycin-resistant strains, it is recommended that trough therapeutic serum concentrations of vancomycin are maintained above 10 mg/L.
Research motivation
There are no recommendations in the literature indicating target vancomycin concentrations to maintain intraoperatively for effective antimicrobial prophylaxis.
Research objectives
The aim of this prospective study was to evaluate the incidence and risk factors for vancomycin concentrations under 10 mg/L in adult patients undergoing cardiac surgery.
Research methods
In this study, the frequency of suboptimal vancomycin levels intraoperatively was investigated in samples collected from cardiac surgery patients receiving a single 1000 mg vancomycin dose.
Research results
We found an incidence of intraoperative potentially suboptimal concentrations of vancomycin in almost 50% of these patients. The multivariate analysis identified female gender, body mass index > 25, and creatinine clearance above 70 mL/min as risk factors for vancomycin levels less than 10 mg/L.
Research conclusions
Although we arbitrarily considered vancomycin levels of 10 mg/L as a cut-off, the findings of our study are interesting because they suggest a high incidence of potentially suboptimal serum concentrations in the case of antimicrobial prophylaxis.
Research perspectives
Further studies will be necessary to define the cut-off of intraoperative vancomycin levels representing the optimal concentration of vancomycin for appropriate antimicrobial prophylaxis in patients undergoing cardiac surgery.
