Short term impact of guidelines on vancomycin dosing and therapeutic drug monitoring
2012 (English)In: International Journal of Clinical Pharmacy, ISSN 2210-7703, Vol. 34, no 2, 282-285 p.Article in journal (Refereed) Published
Background: After medical center implementation of 2009 ASHP/IDSA guidelines, we evaluated the appropriateness of vancomycin dosing and TDM.
Objective: 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.
Method: 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.
Results: 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).
Conclusion: Adoption of the guidelines with associated training resulted in significant short term improvement in vancomycin dosing and TDM.
Place, publisher, year, edition, pages
2012. Vol. 34, no 2, 282-285 p.
Appropriate use, Education, Guidelines, Therapeutic drug monitoring, TDM, Vancomycin
Social and Clinical Pharmacy
IdentifiersURN: urn:nbn:se:uu:diva-174779DOI: 10.1007/s11096-012-9614-6ISI: 000303377900006OAI: oai:DiVA.org:uu-174779DiVA: diva2:529158