Postgraduation Registration Detail

Research Registry No : PRID-00302_V3
 
Registration Date : 2020-07-22
 
Thesis Title : Vancomycin: The Ratio of Plasma Trough Concentration to Minimum Inhibitory Concentration and Microbiological Treatment Outcome in Haemodialysis Patients with End Stage Renal Disease
 
Author Name : Nu Shwe Wah
 
City : Yangon
 
State/ Region : Myanmar
 
Field of Thesis : Pharmacology
 
Education Status : M.Med.Sc.(Pharmacology)
 
Host Department Address : No 245,Myo Ma Kyaung Street, Lanmadaw township, yangon
 
Supervisor's Name : Dr. Thida Tun
 
Supervisor's Designation : Associate Professor
 
Supervisor’s Home Department :
 
Year of Post Graduation : 2020
 
Name and Placement of University : University of Medicine 1
 
Academic Level : MMedSc
 
Thesis Notes for Specialty : M.Med.Sc.(Pharmacology)
 
Abstract : \r\n This study aimed to determine the ratio of Ctrough to MIC of vancomycin and the treatment outcome in haemodialysis patients with end stage renal disease.\r\n The study was hospital based descriptive study done in 19 haemodialysis patients (twice weekly) with end stage renal disease admitted to Yangon 500-bedded Speciality Hospital, Thingan Gyun General Hospital, North Okkalapa General Hospital and Jivita Dana Sanga Hospital who were diagnosed as Gram (+) bacteremia and were prescribed IV vancomycin by the renal physicians of respected wards. The dosing regimen of vancomycin is 25-30 mg/ kg as loading dose followed by 500 mg at each haemodialysis session as maintenance dose. The HPLC-UV method was used to monitor the plasma trough level of vancomycin at the steady state concentration; within half-hour before the administration of third dose of vancomycin. The MICs of individual patients were obtained from the blood culture and sensitivity test results before vancomycin administration. \r\n In pre-vancomycin blood culture and sensitivity tests, 2 patients had methicillin resistant Staphyloccus aureus, 2 patients had methicillin resistant Staphylococcus strain, 8 patients had Staphylococcus aureus, 5 patients had Staphylococcus epidermidis and 2 patients had Enterococcus faecium. Treatment outcomes were evaluated by the results of blood culture and sensitivity after the completion of fifth dose of vancomycin. \r\nEight out of 19 patients (42.1%) were found to have normal range of plasma trough level of vancomycin (5-20 mg/ L) while 2 patients (10.5%) had plasma trough level of vancomycin <5 mg/ L and 9 patients (47.4%) had plasma trough level of vancomycin > 20mg/ L. Four patients had MIC value of 0.5 mg/ L while the 15 patients had that of 1 mg/ L. \r\nAccording to the ratio of Ctrough to minimum inhibitory concentration (MIC), 2 patients (10.5%) had the ratio of Ctrough/ MIC < 5, 5 patients (26.3%) had the ratio of Ctrough / MIC 5-20 and 12 patients (63.2%) had the ratio of Ctrough / MIC more than 20. \r\nThe blood culture and sensitivity tests after completion of fifth dose of vancomycin showed that 12 patients (63.2%) had sterile blood culture and sensitivity results while 7 patients (36.8%) had blood culture and sensitivity results positive for Gram (-) bacteria which do not include in the spectrum of vancomycin. There was absence of persistent Gram (+) bacteremia in all the patients after completion of fifth dose of vancomycin, the success rate of treatment outcome of vancomycin was considered to be 100%.
 
IRB/PRC/ERC Approval Date : 2019-02-15
 
Placement of IRB/PRC/ERC : University of Medicine (1), Yangon
 
IRB/PRC/ERC Approval Letter/PRC/Document : 22072020080409Ethicalreviewonpostgraduatestudy.pdf
 
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