Transl Clin Pharmacol.  2016 Sep;24(3):124-126. 10.12793/tcp.2016.24.3.124.

Therapeutic drug monitoring of vancomycin in a patient with Duchenne muscular dystrophy (DMD): A case report

• Lee SW
• Yoon S
• Yu KS
• Lee S

• KMID: 2351797
• DOI: http://doi.org/10.12793/tcp.2016.24.3.124

Abstract

Vancomycin is a widely used glycopeptide antibiotic that requires therapeutic drug monitoring (TDM) owing to its narrow therapeutic window. It is primarily eliminated by renal excretion; thus, estimating the renal function of a patient is vital in the TDM of vancomycin. In patients with Duchenne muscular dystrophy (DMD), it is difficult to estimate the glomerular filtration rate using the serum creatinine level owing to the pathophysiological nature of the disease. Here, we report a case of a patient in whom TDM of vancomycin was performed, and explore the appropriate methods for evaluating renal function in patients with DMD based on serum levels of creatinine and cystatin C.

Keyword

Vancomycin; Therapeutic drug monitoring; Renal function; Serum creatinine; Duchenne muscular dystrophy

MeSH Terms

Creatinine
Cystatin C
Drug Monitoring*
Glomerular Filtration Rate
Humans
Muscular Dystrophy, Duchenne*
Renal Elimination
Vancomycin*
Creatinine
Cystatin C
Vancomycin

Reference

1.Moellering RC Jr. Vancomycin: a 50-year reassessment. Clin Infect Dis. 2006. 42:S3–S4.

2.Matzke GR., Zhanel GG., Guay DR. Clinical pharmacokinetics of vancomycin. Clin Pharmacokinet. 1986. 11:257–282.

3.Perrone RD., Madias NE., Levey AS. Serum creatinine as an index of renal function: new insights into old concepts. Clin Chem. 1992. 38:1933–1953.

4.Bushby K., Finkel R., Birnkrant DJ., Case LE., Clemens PR., Cripe L, et al. Diagnosis and management of Duchenne muscular dystrophy, part 1: diagnosis, and pharmacological and psychosocial management. Lancet Neurol. 2010. 9:77–93. DOI: doi: 10.1016/S1474-4422(09)70271-6.

5.Viollet L., Gailey S., Thornton DJ., Friedman NR., Flanigan KM., Mahan JD, et al. Utility of cystatin C to monitor renal function in Duchenne muscular dystrophy. Muscle Nerve. 2009. 40:438–442. DOI: doi: 10.1002/mus.21420.

6.Herget-Rosenthal S., Bökenkamp A., Hofmann W. How to estimate GFR-serum creatinine, serum cystatin C or equations? Clin Biochem. 2007. 40:153–161.

7.Filler G., Bökenkamp A., Hofmann W., Le Bricon T., Martínez-Brú C., Grubb A. Cystatin C as a marker of GFR—history, indications, and future research. Clin Biochem. 2005. 38:1–8.

8.Larsson A., Malm J., Grubb A., Hansson LO. Calculation of glomerular filtration rate expressed in mL/min from plasma cystatin C values in mg/L. Scand J Clin Lab Invest. 2004. 64:25–30.

9.Grubb A., Nyman U., Björk J., Lindström V., Rippe B., Sterner G, et al. Simple cystatin C–based prediction equations for glomerular filtration rate compared with the modification of diet in renal disease prediction equation for adults and the Schwartz and the Counahan–Barratt prediction equations for children. Clin Chem. 2005. 51:1420–1431.

10.Tan GD., Lewis AV., James TJ., Altmann P., Taylor RP., Levy JC. Clinical Usefulness of Cystatin C for the Estimation of Glomerular Filtration Rate in Type 1 Diabetes Reproducibility and accuracy compared with standard measures and iohexol clearance. Diabetes Care. 2002. 25:2004–2009.

11.Cockcroft DW., Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron. 1976. 16:31–41.

12.Schwartz GJ., Brion LP., Spitzer A. The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children, and adolescents. Pediatr Clin North Am. 1987. 34:571–590.

13.Levey AS., Greene T., Kusek JW., Beck GJ., Group MS. A simplified equation to predict glomerular filtration rate from serum creatinine [Abstract]. J Am Soc Nephrol. 2000. 11:A0828.

14.Inker LA., Schmid CH., Tighiouart H., Eckfeldt JH., Feldman HI., Greene T, et al. Estimating glomerular filtration rate from serum creatinine and cystatin C. N Engl J Med. 2012. 367:20–29. DOI: doi: 10.1056/NEJMoa1114248.