Vancomycin dosing and monitoring in the intensive care unit: Guideline adherence and efficacy
Abstract
BACKGROUND
Vancomycin has a narrow therapeutic window requiring careful drug dosing and monitoring to ensure efficacy while avoiding toxicity. Although protocolised prescribing and monitoring are recommended in antibiotic guidelines, adherence in clinical practice is infrequently reported.
OBJECTIVES
We sought to describe compliance with a new vancomycin dosing guideline in the intensive care unit (ICU) and to describe its efficacy in reaching serum levels within the therapeutic range.
METHODS
In this single-centre retrospective observational study, we assessed compliance with, and efficacy of a newly implemented vancomycin prescribing protocol. All ICU patients prescribed intravenous vancomycin between May and July 2024 were screened for inclusion. Collected data included indication, weight, age, creatinine, urine output, loading dose, maintenance dose, plasma vancomycin concentration, and timing of monitoring. Augmented renal clearance (ARC) was defined as a creatinine level below the reference range and/or an urine output >3 L in 24 h.
RESULTS
A total of 148 patients were included. Protocol compliance was 82% for the loading dose (101/123), 49% for maintenance dosing (49/101), and 51% for timing of monitoring (46/91). Compliance across all protocol domains occurred in 27% of instances (17/64). Therapeutic drug levels were achieved in only 20% of prescribing episodes. Central nervous system (CNS) infection vs non-CNS infection (odds ratio [OR]: 9.5, 95% confidence interval…
Read the paper
Related studies
- Safety and efficacy of COVID‐19 vaccines: A systematic review and meta‐analysis of controlled and randomized clinical trials
- Accuracy Comparison between Robot-Assisted Dental Implant Placement and Static/Dynamic Computer-Assisted Implant Surgery: A Systematic Review and Meta-Analysis of In Vitro Studies
- Determinants of passive antibody efficacy in SARS-CoV-2 infection: a systematic review and meta-analysis
- Cleaning efficacy of EDDY versus ultrasonically-activated irrigation in root canals: a systematic review and meta-analysis
- Bonding Efficacy of Universal Resin Adhesives to Zirconia Substrates: Systematic Review and Meta-Analysis
- In vitro antimicrobial activity of extracts and essential oils of Cinnamomum, Salvia, and Mentha spp. against foodborne pathogens: A meta-analysis study
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.