• 한국임상약학회지
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• 제6권2호
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• pp.7-13
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• 1996

The purposes of this study were to define the pharmacokinetic parameters of vancomycin in Korean neonates, to evaluate current neonatal vancomycin dosing guideline being used in a teaching hospital, and to develop the optimal vancomycin dosing guideline. The evaluation of 35 sets of peak and trough concentrations drawn on current dosing regimen showed that $29\%$ of peak concentrations and $46\%$ of though concentrations were within therapeutic range. Otherwise, pharmacokinetic parameters, based on 62 sets of peak and trough serum concentrations obtained from 39 neonates, showed that mean vancomycin clearance (CL), volume of distribution (Vd), and terminal elimination half-life were $0.13\pm0.08\;L/hr,\;0.94\pm0.48\;L,\;and\;5.6\pm2.13$ hours, respectively. Volume of distribution (Vd) normalized for body weight remained constant throughout PCA range, whereas the absolute CL (r=0.74) and normalized CL (r=0.36) showed high correlation with PCA. Also, the normalized CL showed a strong inverse correlation (r=-0.55) with serum creatinine concentrations (SrCr). Based on the high correlation among PCA serum creatinine concentration, CL, and the daily dosage requirements, the following dosing guideline for vancomycin in neonates was suggested: 10 mg/kg $12{\sim}18$ hourly for < 30 weeks PCA and < 0.6 mg/dl SrCr; 10 mg/kg 18 hourly for < 30 weeks PCA and $0.6{\sim}1.2$ mg/dl SrCr; 10 mg/kg 8 hourly for $30\sim44$ weeks PCA and < 0.6 mg/dl SrCr; 10 mg/kg 12 hourly for $30\sim44$ weeks PCA and $0.6{\sim}1.2$ mg/dl SrCr.

• 한국임상약학회지
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• 제9권1호
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• pp.1-14
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• 1999

Vancomycin-resistant Enterococci (VRE) have recently emerged in Korean hospitals, as well as in those of other countries. VRE have been partially attributed to the overuse and misuse of vancomycin. The mecbanisms of VRE resistance are related to VanA, VanB, and VanC. Both VanA and VanB produce abnormal ligase enzymes to form D-ala-D-lactate termini in E. faecium and E. faecalis, instead of D-ala-D-ala termini. Meanwhile, Van C produces D-ser-D-ala termini in E. gallinarum and E. casseliflavus. These abnormal termini have a low affinity to vancomycin. As a result, VRE avoid the activity of vancomycin by these mechanisms. Unfortunately, there is no approved therapy for the treatment of VRE. Thus, available but uncommonly prescribed antibiotics (due to their toxicity or unproven efficacy) may become possible options. They include chloramphenicol, novobiocin, fosfomycin, and bacitracin. The combination therapy of available agents may also be the other options. They include high doses of a penicillin- or ampicillin-aminoglycoside combination, high doses of an ampicillin/sulbactam and aminoglyoosidcs combination, an ampicillin and vancomycin combination, and a ciprofloxacin, aminoglycosides, and rifampin combination. With respect to the near future, many types of investigational agents will most likely expand their treatment options for VRE. Teicoplanin, a glycopeptide, can be used for VanB- and VanC-related VRE. LY333328, a new generation of glycopeptide, is effective in treating VanA as well as VanB and VanC. RP59500 (quinupristin/dalfopristin), a streptogramin, is effective in treating vancomycin-resistant E. faecium. New generation quinolones (especially clinatloxacin) are potential options for the treatment of VRE, even though they cannot work as effectively against VRE as they can against Staphylococci. Both glycylcyclines (a new generation of tetracyclines) and ketolides (a new generation of macrolides) show good activity against Enterococci, regardless of vancomycin susceptibility. Oxazolidinones (i. e. eperezolid and 1inezolid) and everninomicins (i. e. SCH27899) are new groups of antibiotics, which also demonstrate good activity against VRE. It is imperative that clinical pharmacists take the responsibility of investigating new treatment options for VRE in order to combat this growing problem throughout the world.

• 한국임상약학회지
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• 제11권2호
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• pp.62-67
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• 2001

Paclitaxel과 vancomycin을 $5\%$ 포도당주사액, $0.9\%$ 염화나트륨주사액 또는 하트만용액과 함께 Y-Site 장치를 써서 환자에게 주입할 때 두 약물의 안정성에 관하며 면구하였다. Paclitaxel 0.3 mg/ml 및 1.2 mg/ml과 vancomycin 1 mg/ml, 5 mg/ml 및 10 mg/ml을 각각 1 : 1로 혼합한 후 0, 1, 2, 4, 12시간 시점에서 두 약물의 농도를 HPLC로 분석하였다, 방해물질에 의한 분석오차를 줄이기 위해 분석법을 여러상태에서 확인하였으며 각 농도에서 3차례씩 실험하였고 각 샘플은 반복하여 HPLC로 분석하였다. 분석전에 각 시료의 투명도, 색의 변화, 침전상태 및 pH를 검사하였다. Paclitaxel 0.3 mg/ml 및 1.2 mg/ml와 vancomycin 1 mg/ml, 5 mg/ml 및 10 mg/mt를 각각 혼합하였을 때 12시간 동안 안정하였으며 주사액의 혼탁이나 색의 변화 및 침전은 나타나지 않았으며 pH도 변하지 않았다.

• 한국응용약물학회:학술대회논문집
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• 한국응용약물학회 1994년도 춘계학술대회 and 제3회 신약개발 연구발표회
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• pp.331-331
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• 1994

최근 개발된 Teicoplanin은 glycopeptide계의 항생제로서 vancomycin과 그 작용 기전이 비슷하지만, 근육 주사가 가능하고, 반감기가 길어서 하루 한번 주사하여도 되며, 빨리 주입하더라도 red man syndrome이생기지 않는 장점이 있다. 이 연구의 목적은 그람 양성균에 의한 감염증을 치료하는데 teicoplanin이 효과적이고 안전한지를 vancomycin과 비교하는 것이다. 대상 환자 및 방법: 서울대학교병원에 입원하여 그람 양성균 감염증이 확인되거나 강력히 의심되는 환자를 대상으로 하였다. 감염증의 종류는 패혈증, 골수염, 하기도 감염증, 감염성 관절염, 피부 및 연조직 감염증, 요로 감염증으로 하였다. 대상 환자를 무작위로 teicoplanin또는 vancomycin군에 무작위 배정하였다. Teinoplanin은 처음에 loading을 위하여 400mg씩 12시간마다 3회 주사하고 이후에는 증증 감염이면 하루에 400mg, 중등중이면 200mg씩을 주사하였다. Vancomycin은 500mg을 6시간마다 또는 1. 0g을 12시간마다 정맥주사하였다. 치료 기간은 요로 감염증 5-10일, 하기도 감염증 5-10일, 패혈증 14-21일, 골수염 21-42일, 세균성 관절염 21-42일, 피부 및 연조직 감염증 5-10일로 하였다.

• Journal of Pharmaceutical Investigation
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• 제27권1호
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• pp.51-56
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• 1997

This study was attempted to investigate the pharmacokinetic interaction of vancomycin (10 mg/kg, i.v.) and probenecid (7.5. 15, and 30 mg/kg, oral) in rabbits. The area under curve (AUC) of plasma vancomycin concentration was significantly increased (p<0.01) in rabbits when the probenecid was coadministrated. Volume of distribution (Vd) was significantly decreased (p<0.05) in rabbits coadministrated with probenecid (15 and 30 mg/kg) and total body clearance (CLt) was decreased significantly (p<0.05. p<0.01) in rabbits coadministrated with probenecid (7.5, 15 and 30 mg/kg). There was significant correlation between AUC and probenecid dose. From the results of this experiment, it is desirable to adjust dosage regimen of vancomycin for reduction of side or toxic effect when the probenecid is coadministered in clinical practice.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제19권3호
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• pp.210-213
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• 2016

Primary sclerosing cholangitis (PSC), a rare progressive liver disease characterized by cholestasis and bile duct fibrosis, has no accepted, effective therapy known to delay or arrest its progression. We report a 15 year old female patient diagnosed with PSC and moderate chronic active ulcerative colitis (UC) who achieved normalization of her liver enzymes and bile ducts, and resolution of her UC symptoms with colonic mucosal healing, after treatment with a single drug therapy of the antibiotic oral vancomycin. We postulate that the oral vancomycin may be acting both as an antibiotic by altering the intestinal microbiome and as an immunomodulator. Oral vancomycin may be a promising treatment for PSC that needs to be further studied in randomized trials.

• Journal of Microbiology
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• 제40권2호
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• pp.170-172
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• 2002

To determine the occurrence of vancomycin-resistant Enterococci in a raw milk sample, raw milk samples were examined for a period of 6 months. Enterococci were isolated directly from Enterococcal selective agar plates supplemented with 2 mg of vancomycin per liter, Nineteen strains were selected and identified by applying the Vitek system. To determine resistance patterns, 19 isolates were tested with vancomycin and teicoplanin. Vancomycin-resistant Enterococci were genotyped by using a PCR analysis and 5 out of 19 isolates were of the VanC type.

• 대한임상검사과학회지
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• 제45권1호
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• pp.1-4
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• 2013

Vancomycin-resistant enterococci (VRE) have emerged as important healthcare-associated infection since last two decades. ChromID VRE agar (cIDVA) is useful for VRE rectal swab screening. We investigated all VRE were isolated on the cIDVA. A total of 363 rectal swabs of 85 patients to test VRE screening were inoculated into bile-esculin (B-E) broth with $6{\mu}g/mL$ vancomycin. After 24 hours incubation, we subcultured B-E broths were changed to black onto cIDVA. All isolates were identified by the MICROSCAN and VITEK2. The vanA gene and vancomycin minimal inhibition concentration (MIC) were detected by PCR and E-test respectively. 277 E. faecium (84.7%), 16 E. faecalis (4.9%), 25 E. avium (7.6%), 8 E. gallinarum (2.4%) and 1 E. raffinosus (0.3%) were isolated. 10.3% of VRE detected on cIDVA were other than E. faecium and E. faecalis that presented various color from colorless to pale violet. All isolates contained vanA and vancomycin MIC were > $256{\mu}g/mL$. VRE isolates other than E. faecium and E. faecalis should be objective to the contact precautions for healthcare-associated infection control if they possess vanA gene. Due to emerging enterococci carrying vanA such as E. avium, E. gallinarum, and E. raffinosus, VRE surveillance should be expanded to all isolates on chromogenic agar.

• 한국미생물·생명공학회지
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• 제42권3호
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• pp.232-237
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• 2014

본 연구에서는 반응액 부피당 표면적(surface area per volume of reaction solution)이 증가된 반코마이신 결정화 공정에서 표면적 증가물질인 실리카겔의 영향을 조사하였다. 표면적 증가물질로 실리카겔을 사용한 경우, 반코마이신 결정화 시간 단축 측면에서 표면적 증가물질인 실리카겔의 기공지름은 $40-60{\AA}$, 입자크기 230-400 mesh 범위가 적절함을 알 수 있었다. 또한 실리카겔의 첨가량이 증가 할수록 반코마이신의 결정 크기가 감소함을 확인할 수 있었다. 실리카겔을 표면적 증가물질로 사용함으로써 표면적 증가물질이 없을 때 보다 결정화에 소요되는 시간을 4배 정도 단축시킬 수 있었다. 이러한 개선된 결정화 방법은 반코마이신 정제 효율 향상에 상당히 기여할 것으로 판단된다.

• 한국임상약학회지
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• 제8권1호
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• pp.13-18
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• 1998

The purpose of this study was to determine pharmacokinetic parameters of vancomycin using the compartment model dependent and compartment model independent analysis in 6 Korean normal volunteers and 8 ovarian cancer patients. Vancomycin was administered 1.0 g bolus by IV infusion over 60 minutes. The elimination rate constant ($\beta$), volume of distribution (Vd), total body clearance (CLt), and area under the plasma level-time curve (AUC) of vancomycin in normal volunteers using the compartment model dependent analysis were $0.150\pm0.030\;hr^{-1},\;32.9\pm2.81\;L/kg,\;5.36\pm0.63\;L/hr,\;and\;186.5\pm20.5\;{\mu}g/ml{\cdot}hr$, respectively. The $\beta$, Vd, CLt, and AUC of vancomycin in ovarian cancer patients using the compartment model dependent analysis were $0.109\;0.008\;hr^{-1},\;41.5\pm3.01\;L/kg,\;4.58\pm0.57\;L/hr\;and\;218.3\pm22.9\;{\mu}g/ml{\cdot}hr$, respectively. There were significant differences (p<0.05,\;p<0.01) in $\beta$, Vd, CLt, and AUC between normal volunteers and ovarian cancer patients. The elimination rate constant (Kel), CLt, and AUC of vancomycin in normal volunteers using the compartment model independent analysis were $0.152\pm0.022\;hr^{-1},\;5.77\pm0.75\;L/hr,\;and\;173.2\pm22.5;{\mu}g/ml{\cdot}hr$, respectively. The Kel, CLt, and AUC of vancomycin in ovarian cancer patients using the compartment model independent analysis were $0.126\pm0.012\;hr^{-1},\;4.96\pm0.55\;L/hr,\;and\;201.7\pm25.6;{\mu}g/ml{\cdot}hr$, respectively. There were significant differences (p<0.05, p<0.01) in Kel, CLt, and AUC between normal volunteers and ovarian cancer patients. And also, there was significant difference (p<0.05) in Kel of vancomycin in ovarian cancer patients between the compartment model dependent and independen analysis. It is necessary for effective dosage regimen of vancomycin in ovarian cancer patient to use these population parameters.