=9��7�~�E�߾��G�������������MLv���O�;&X�� a�L,����� endobj The discussion around the variance between BMD results and ETests on page 10 of the draft Moving away from a single lab-reported number in a range (trough) to using a calculated number (AUC) instead may appear somewhat challenging at first glance. 4 0 obj for the Infectious Diseases Society of America (and the ASHP, PIDS, and SIDP) are now available for public comment.The update, as many expected, recommends moving away from trough targets to AUC24:MIC for the monitoring of vancomycin.

B. Actions may include: preemptive dose adjustment, holding dose, checking leve- l, discussion with provider, reassessing the need for vancomycin therapy. That point made, for methicillin resistant staphylococcus aureus (MRSA) it is also noted that vancomycin MICs have remained constant over time, with ≥90% of isolates having MIC < 1mg/L.Given this, the guidelines suggest that an appropriate level of AUC over 24 hours should be 400-600 mg*hr/L with an assumed minimum inhibitory concentration of 1 mg/L if this is not yet known.For those interested in the laboratory side, the MIC method cited in the new guidelines is broth micro-dilution (BMD). Loading dose by actual body weight. Determination of minimum inhibitory concentrations. IV Vancomycin dosing and monitoring Antibiotic Guidelines Reference Number: 144TD(C)25(H3) Version Number: 6.1 Issue Date: 21/07/2020 Page 1 of 12 It is your responsibility to check on the intranet that this printed copy is the latest version IV Vancomycin dosing and monitoring Antibiotic Guidelines

1 0 obj Munckhof Wendy; et,al. You can also phone us on by Rybak et al. A loading dose will facilitate more rapid attainment of therapeutic target range [4]. For example, a MIC=1mg/L indicates that the visible growth of bacteria is inhibited from 1mg/L of the drug. There are different values for MIC depending on what type of antibacterial drug you use and how resistant a bacteria is to a specific antimicrobial drug. A. “Bayesian programs offer numerous advantages over traditional first-order software…” %PDF-1.5 Get instant access to our concise range of free checklists, tips and templates to support you in successfully transitioning to an AUC-based dosing strategy.Understanding some pharmacokinetics is important to understand how monitoring can be performed for dosing to an Area Under the Curve (AUC) target. The research suggests for many patients, an effective AUC24:MIC target of 400-600 mg.h/L can be achieved with significantly lower trough concentrations than previously recommended.An AUC24 of 400-600 mg.h/L is the recommended target to “achieve clinical efficacy while improving patient safety”. $$����Puˁ¢�a��z��6i&J_�I��;3-�����z�y���V�ߛ_�XT�OE��cSܯ^^������,��r U�����9�$~J -с#Bi�z�3/��{�=���T�yvž�l&P4�ka��V@���&�~~�m��� ��X��j�`�A��������;\�-�������Do��t֬B@�iyq�ݥ�����jD�!�9�� zB,�$��(�f�� <> <>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 595.32 841.92] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> %���� Allow sufficient time for drug clearance before restarting next dose. DoseMeRx is used to dose vancomycin to both trough and AUC-based targets. “Bayesian programs offer numerous advantages over traditional first-order software…”Acute kidney injury occurs in between 5-43% of patients, with an attributable risk to vancomycin of 59%. Higher Andrews, JM.

2 0 obj June 2019. Bayesian dosing is shown in the guidelines to require only half the levels of other manual approaches. endobj Loading dose Based on the currently available evidence, clinical data support a loading dose of 25mg / kg (actual body weight) [3]. Vancomycin Dosing, Administration & Monitoring Guidelines for Adults Indications Vancomycin use is limited to the following indications (unless use is in accordance with an approved protocol or approval is obtained from Infectious Diseases): • Empiric therapy for severe community-acquired sepsis Serum vancomycin level taken towards the end of the dosing interval, approximately one hour prior to next dose . Do not restart vancomycin until the random/trough level is estimated or confirmed to be at/near 10-20 mg/dl. is the recommended method for dosing vancomycin.

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