Short term impact of guidelines on vancomycin dosing and therapeutic drug monitoring.

International Journal of Clinical Pharmacy
Maria SwartlingB Joseph Guglielmo

Abstract

After medical center implementation of 2009 ASHP/IDSA guidelines, we evaluated the appropriateness of vancomycin dosing and TDM. Our primary objectives were to assess short term effects on (1) appropriateness of initial vancomycin dosing, (2) appropriateness of sampling of plasma levels, before and after implementation of guidelines. The study was conducted in two phases, pre-guideline and post-guideline implementation. The interventions included (1) Nurses and phlebotomist education regarding the appropriate timing of vancomycin sampling, (2) A nomogram for appropriate initial dosing that was distributed to medical staff. Patient demographics, dosing and timing of sampling were collected in eligible patients and assessed for appropriateness. The appropriateness of the prescribed dose increased from 51% (128/253) of patients during the pre period to 78% (155/200) (p < 0.0001) during the post period. Similarly, overall appropriateness of sampling of vancomycin troughs at steady state improved from 36% (63/173) pre to 55% (106/191) (p < 0.03) post. Specifically, the appropriate timing of troughs (within 30 min of the next dose) increased from 37% (64/173) during the pre period to 78% (149/191) during the post period (p < 0.0001)....Continue Reading

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Citations

Jul 24, 2015·SpringerPlus·Anthony P CardileGünther Hsue
Nov 15, 2013·American Journal of Clinical Pathology·Stacy E F MelansonMilenko J Tanasijevic
Aug 30, 2018·Pharmacology Research & Perspectives·Joaquim F MonteiroPaula Fresco
Jan 27, 2018·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Vincent Peyko, Michelle Friedman-Jakubovics
Nov 19, 2014·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·David J GagnonLynne Sylvia
Apr 3, 2014·Therapeutic Drug Monitoring·Caroline Fonzo-ChristePascal Bonnabry
Jun 19, 2019·Internal Medicine Journal·Bethany A Van DortRichard O Day
May 21, 2020·British Journal of Clinical Pharmacology·Bradley D MenzStephanie E Reuter
Jul 30, 2018·European Journal of Clinical Pharmacology·Joanne Oi Sze ChanRichard Osborne Day
Jun 28, 2018·International Journal of Clinical Pharmacy·Jun Jie Benjamin SengMooi Heong Tan
Mar 27, 2021·British Journal of Clinical Pharmacology·Jane E CarlandRichard O Day
Apr 30, 2021·International Journal of Clinical Pharmacy·Tatjana Van Der HeggenPieter A J G De Cock

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