{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T23:46:54Z","timestamp":1777420014360,"version":"3.51.4"},"reference-count":17,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2006,3,1]],"date-time":"2006-03-01T00:00:00Z","timestamp":1141171200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2006,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To report a case in which vancomycin clearance was used to determine the daptomycin dosing interval in a morbidly obese patient with renal impairment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Summary:<\/jats:title>\n                    <jats:p>A 46-year-old man (209 kg; 178 cm) failed a 42 day course of vancomycin therapy for treatment of a methicillin-resistant Staphylococcus aureus\u2013infected wound and cellulitis. The median trough vancomycin concentration was 12.6 \u03bcg\/mL (range 7.3\u201324.1) through his course of therapy. Estimation of creatinine clearance (Clcr) was confounded in this clinical scenario, given the patient's weight and a lack of valid equations in this patient population. Daptomycin was administered empirically at 6 mg\/kg dosed every 48 hours based on estimated clearance from measured vancomycin concentrations. Steady-state plasma concentrations of daptomycin were determined, and the daptomycin half-life in this patient was more accurately estimated using vancomycin clearance as a surrogate. In addition, a 4 mg\/kg dose of daptomycin would have been sufficient based on plasma concentrations. The patient demonstrated rapid clinical improvement and remained free of cellulitis for 6 months after completion of daptomycin and a 12 week course of trimethoprim\/sulfamethoxazole.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>The dosing interval of daptomycin is adjusted based on Clcr. However, estimation of Clcr is difficult in morbidly obese patients with renal impairment, given a lack of valid equations. In this clinical scenario, vancomycin concentrations were used to estimate Clcr and served as a surrogate measure to determine the daptomycin dosing interval. Measured daptomycin concentrations validated this approach and confirmed the inadequacy of commonly used Clcr equations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In this clinical scenario, vancomycin concentrations more accurately estimated Clcr, thereby facilitating determination of the daptomycin dosing interval.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1345\/aph.1g509","type":"journal-article","created":{"date-parts":[[2006,2,28]],"date-time":"2006-02-28T21:48:20Z","timestamp":1141163300000},"page":"553-558","source":"Crossref","is-referenced-by-count":7,"title":["Using Vancomycin Concentrations for Dosing Daptomycin in a Morbidly Obese Patient with Renal Insufficiency"],"prefix":"10.1177","volume":"40","author":[{"given":"Manjunath P","family":"Pai","sequence":"first","affiliation":[{"name":"College of Pharmacy, University of New Mexico, Albuquerque, NM"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renee-Claude","family":"Mercier","sequence":"additional","affiliation":[{"name":"College of Pharmacy, University of New Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah E","family":"Allen","sequence":"additional","affiliation":[{"name":"School of Medicine, University of New Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2006,3,1]]},"reference":[{"key":"bibr1-aph.1G509","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.14.1723"},{"key":"bibr2-aph.1G509","doi-asserted-by":"publisher","DOI":"10.2165\/00128071-200203070-00006"},{"key":"bibr3-aph.1G509","doi-asserted-by":"publisher","DOI":"10.1159\/000180580"},{"key":"bibr4-aph.1G509","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.V451159"},{"key":"bibr5-aph.1G509","doi-asserted-by":"publisher","DOI":"10.1152\/ajprenal.2000.278.5.F817"},{"key":"bibr6-aph.1G509","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200464040-00009"},{"key":"bibr7-aph.1G509","first-page":"474","volume-title":"Basic clinical pharmacokinetics","author":"Winters ME","year":"1994","edition":"3"},{"key":"bibr8-aph.1G509","doi-asserted-by":"publisher","DOI":"10.1007\/s002280050524"},{"key":"bibr9-aph.1G509","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.48.8.2799-2807.2004"},{"key":"bibr10-aph.1G509","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.49.6.2260-2266.2005"},{"key":"bibr11-aph.1G509","doi-asserted-by":"publisher","DOI":"10.1086\/420818"},{"key":"bibr12-aph.1G509","volume-title":"Methods for dilution antimicrobial susceptibility testing for bacteria that grow aerobically","year":"2003","edition":"6"},{"key":"bibr13-aph.1G509","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.49.8.3435-3441.2005"},{"key":"bibr14-aph.1G509","doi-asserted-by":"publisher","DOI":"10.1592\/phco.25.4.491.61034"},{"key":"bibr15-aph.1G509","doi-asserted-by":"publisher","DOI":"10.1592\/phco.2005.25.9.1286"},{"key":"bibr16-aph.1G509","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.47.4.1318-1323.2003"},{"key":"bibr17-aph.1G509","doi-asserted-by":"publisher","DOI":"10.1177\/0091270004269562"}],"container-title":["Annals of Pharmacotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.1G509","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.1G509","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:12:10Z","timestamp":1777374730000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1345\/aph.1G509"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,3]]},"references-count":17,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2006,3]]}},"alternative-id":["10.1345\/aph.1G509"],"URL":"https:\/\/doi.org\/10.1345\/aph.1g509","relation":{},"ISSN":["1060-0280","1542-6270"],"issn-type":[{"value":"1060-0280","type":"print"},{"value":"1542-6270","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,3]]}}}