The Most Suitable Dosage Regimen of Antibiotics for MRSA from Economical and Clinical Aspects.

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Purpose. The purpose of the study was to evaluate the most suitable dosages and dosing intervals on the basis of pharmacokinetic parameters for three kinds of antibiotics for MRSA infection, vancomycin (VCM), arbekacin (ABK) and teicoplanin (TEIC) from economical and clinical point of view.Methods. On the basis of pharmacokinetic mean-arameters of VCM obtained from Japanese, the computer simulation-study was performed by using one-compartment model analysis. Regarding to ABK and TEIC, the pharmacokinetic study was performed on each plasma concentration obtained from MRSA-patients by using Sawchuk-Zaske method.Results. In the case of VCM, we concluded that 1300 mg of VCM given once daily on commencing treatment of MRSA infection is the most suitable dosage regimen for Japanese adult patients because the regimen enable to increase the most suitable VCM peak concentration of 25-40 ug/mL and traugh level of under 10 ug/mL.In contrast, The dosage recommended in the Japanese version of the V … More CM package insert (500 mg of VCM given four times a day, or 1000 mg of VCM given twice a day) could not satisfy the concentration described above. From the economical point, the two weeks administration of VCM at a dose of 1300 mg once a day is cheaper by \67, 550 than the administration method described in package insert. In the case of ABK, 200 mg of ABK given once a day is found to be the most suitable dasage resimen for Japanese adult patient. Further, the pharmacokinetic parameter of TEIC was examined in 24 of adult MRSA patients. As a result, it was clarified that volume of distribution and clearance for TEIC are 0.6436 L/kg and 0.0018 L/kg/h, respectively. From the result, the administration of TEIC at a dose of 200 mg once a day is not enough to obtain an effective peak concentration of TEIC.The dose of 400 mg a day is found to be the most suitable dosage.The results obtained from the study gave the most useful clue for considering drug administration both from clinical and economical point of views. Less