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Manuela Velázquez Prieto
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Jaime E. Poquet Jornet
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Margarita Pamplona
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Volume 19 - Issue 6, November-December 2017
SHORT REPORTS
OPTIMIZATION OPPORTUNITY OF VANCOMYCIN DOSING STRATEGY: APPLICATION OF PHARMACOKINETIC CRITERIA
LÓPEZ ASPIROZ ELENA, SECO MORO MARÍA NOELIA, TAPIA SOLASCASAS DIANA, GARCÍA GIL MARIO


Objectives: To assess the adequacy of vancomycin use in hospitalized patients in order to identify dose optimization opportunities for clinical pharmacists. Steady state plasma concentrations were estimated for different prescribed vancomycin dosage regimens and then compared to recommended target concentrations considering patient clinical status.

Method: A retrospective, single-center study of patients who initiated intravenous vancomycin treatment in November 2015 was conducted. Vancomycin plasma concentrations were analyzed using homogeneous turbidimetric immunoassay (QMS). Pharmacokinetic (PK) analysis was performed with the clinical software PKS (Abbott) using a Bayesian approach.

Results: Twenty-six patients were included; 55 dosage regimens and 43 vancomycin plasma concentrations were considered for PK analysis. After laboratory results and/or dosage adjustments, two regimens led to optimal exposures, while the remaining 53 (96.3%) were outside target concentrations, including sub-therapeutic and/or potentially toxic estimated concentrations.

Conclusions: The results highlight an important opportunity for improving vancomycin management based on dosage individualization using PK criteria.

DOSAGE ADJUSTMENTS – NEPHROTOXICITY – POPULATION PHARMACOKINETICS –
THERAPEUTIC DRUG MONITORING – VANCOMYCIN



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