Factors influencing neonatal therapeutic effect of anti-MRSA drugs

[Analysis of factors affecting long-term administration of anti-methicillin resistant Staphylococcus aureus (MRSA) drugs]

In this study, we aimed to determine an index of anti-MRSA drugs for long-term treatment. We examined adult patients to whom the anti-MRSA drugs arbekacin sulfate (ABK), vancomycin hydrochloride (VCM), and teicoplanine (TEIC) had been administered in the St. Marianna University School of Medicine, Yokohama City Seibu Hospital, for 1, year. The number of patients treated for>or==14 days was 22 (31%) among 71 patients. Immunosuppressive agent positivity (p=0.07), albumin (ALB) level of <or==2.5 g/dl (p=0.03), and C-reactive protein (CRP) level of >or==10 mg/dl (p=0.01),%STAB >or==15% (p=0.11), and the period until the blood drug level is measured (p=0.06) were analyzed with respect to the differences between both groups by univariate analysis. An ALB level of <or==2.5 g/dl was a significant factor as determined by multivariate logistic analysis (p=0.04). It is thought that it is necessary to base long-term administration on necessity in patients with low albumin levels in blood, to consider the appropriate treatment and nutrition management together, and to consider the appropriate treatment depending on the early stage of the blood drug level, and to promote the proper use of drugs.

[Analysis of factors in selecting anti-methicillin-resistant Staphylococcus aureus drugs by doctors]

Three types of medication, Arbekacin, Vancomycin, and Teicoplanin, are used primarily to treat MRSA infections. These medications differ in their respective anti-bacterial actions, antibacterial spectrums, and pharmacokinetics. Proper use and dosage is required, and is based on patient background and the conditions of infection, among other factors. This study was conducted for a period of over one year at St. Marianna University School of Medicine, Yokohama City Seibu Hospital. It was designed to compare the conditions as they related to why doctors ordered a certain drug, the background, and their clinical examination values. The tendency to avoid selection of Arbekacin Sulfate (ABK) for patients who had kidney dysfunction was recognized, although there were a few exceptions made. Other than that, there were not any standard criteria set in selecting which medication to prescribe. Therefore, it is necessary to examine the appropriateness of the selection since ordering anti-MRSA medication seemed to depend on each doctor's own experience. Serum concentration was measured in order to avoid any side effects. Moreover, cases of young people, normal renal function and malignant tumor patients were recognized in which serum concentration of the anti-MRSA medications was not within the therapeutic range of therapeutic drug monitoring (TDM). This was to show that there is a possibility the medications involved were not sufficiently effective. Therefore, in the future it will be necessary to ensure that proper dosing instructions are followed.