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How Well is the Target Concentration of Vancomycin Achieved in Intensive Care Unit Patients?
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
2018 (English)Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
Abstract [en]

How Well is the Target Concentration of Vancomycin Achieved in Intensive Care Unit Patients?

Paula Hansson

Degree Project in Pharmacotherapy 30 hp, Programme of Pharmacy

Biosciences of Pharmacokinetics and Drug Therapy

Supervisor: Annabel Ekberg

Examiner: Agneta Freijs

 

Introduction: Vancomycin has a therapeutic interval of 15-20 mg/L and concentrations outside the interval increases the risk of adverse effects, therapeutic failure and resistance development. Aim: To investigate how well trough concentrations of vancomycin corresponds to the recommended range of target concentration in patients in intensive care units (ICUs). Materials and Methods: A retrospective observational, study was performed at Uppsala University Hospital, Sweden. Data were extracted from electronical journals; MetaVision® and Cosmic® R8.1. One hundred sixty-four patients treated with intravenous vancomycin at any of the four ICUs; Central Intensive Care Unit (CICU), Thorax Intensive Care Unit (TICU), Burn Injury Intensive Care Unit (BIICU), Neurologic Intensive Care Unit (NICU) were included. Results: 922 vancomycin concentrations were registered in 185 cases of vancomycin treatment in 164 patients. More than half (54.7%%) of all the trough concentrations were outside of target range, 21.8% were subtherapeutic and 32.9% supratherapeutic. Generally, patients in the CICU and TICU more frequently had supratherapeutic concentrations and patients treated in the BIICU and NICU more often had subtherapeutic concentrations. There were 147 cases of initiated therapy at any of the four ICUs and 61.2% started with a loading dose. A majority of cases (74%) had >1 trough concentration outside of target range and 55% of these non-therapeutic concentrations led to a change in dose regimen. Conclusions: More than half of measured vancomycin concentrations were outside of recommended target range. Monitoring and dose adjustments of vancomycin in patients treated in an ICU may be improved.

Place, publisher, year, edition, pages
2018.
National Category
Pharmaceutical Sciences
Identifiers
URN: urn:nbn:se:uu:diva-348682OAI: oai:DiVA.org:uu-348682DiVA, id: diva2:1198196
External cooperation
Akademiska sjukhuset
Subject / course
Pharmacotherapy
Educational program
Master of Science Programme in Pharmacy
Supervisors
Examiners
Available from: 2018-04-18 Created: 2018-04-16 Last updated: 2018-04-18Bibliographically approved

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