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Impact of weight-based dosing on vancomycin dosing and trough levels
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|Title:||Impact of weight-based dosing on vancomycin dosing and trough levels|
|Authors:||Bello, Erlaine F.|
|Issue Date:||May 2014|
|Publisher:||[Honolulu] : [University of Hawaii at Manoa], [May 2014]|
|Abstract:||Background: In 2009, the American Society of Health System Pharmacists (ASHSP), Infectious Diseases Society of America (IDSA) and Society of the Infectious Diseases Pharmacists (SI DP) released a consensus statement on vancomycin dosing and monitoring. The appropriateness of these guidelines for a local population, particularly the subset of obese patients, has not been well-studied.|
Methods: A retrospective chart review was conducted on patients hospitalized at an acute care, university-affiliated, community hospital who received intravenous vancomycin for suspected/documented infections prior to and after implementation of the 2009 guidelines. Preguidelines, patient received vancomycin, 1 gram every 12 hours. After the guidelines were implemented, patients were dosed on actual body weight (ABW), lS-20mg/kg, or 2S-30mg/kg in seriously ill patients, every 8-12 hours. We compared the frequency of achieving therapeutic troughs, nephrotoxicity and trough group levels stratified by Body Mass Index (BMI).
Results: There were no significant differences in achieving therapeutic troughs and nephrotoxicity. But when adjusted for BM I, was a significant difference in proportion of trough levels when between the two groups, p=0.0109. However, a large number of patients in the conventionally-dosed group were excluded due to inconsistent dosing. In the ABW-dosed group, there was a high number of supratherapeutic trough levels in 48% of patients with BMls >3S, p=O.OOS Conclusions: Obese patients may require an alternate dosing strategy as the ABW-dosing based on the 2009 national guidelines resulted in supra-therapeutic levels in patients with high BMls. Implementing guidelines-based monitoring resulted in more consistently and appropriately drawn trough levels.
|Description:||M.S. University of Hawaii at Manoa 2014.|
Includes bibliographical references.
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|Appears in Collections:||M.S. - Biomedical Sciences|
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