Articles: vancomycin-administration-dosage.
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Am J Health Syst Pharm · Jan 2010
Implementation and evaluation of vancomycin nomogram guidelines in a computerized prescriber-order-entry system.
The implementation and evaluation of vancomycin nomogram guidelines in a computerized prescriber-order-entry (CPOE) system are described. ⋯ A vancomycin nomogram implemented into a CPOE system increased the likelihood of patients receiving an initial vancomycin regimen that coincided with the nomogram's recommendations.
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Int. J. Antimicrob. Agents · Dec 2009
Nephrotoxicity of continuous versus intermittent infusion of vancomycin in outpatient parenteral antimicrobial therapy.
Intravenous (i.v.) vancomycin is increasingly used as outpatient parenteral antimicrobial therapy (OPAT). Despite the potential advantages of administration by continuous infusion (CI) compared with intermittent infusion (II), the relative nephrotoxicity of these two modes of delivery has not been well established. We compared the rate of nephrotoxicity of vancomycin given by CI and II. ⋯ Both in unadjusted and adjusted analyses, vancomycin CI was associated with a slower onset of nephrotoxicity but not a lower prevalence of nephrotoxicity. Both groups received a similar cumulative vancomycin dose. In adult OPAT patients with normal renal function, vancomycin CI was associated with a slower onset of nephrotoxicity.
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Vancomycin has been recommended as the treatment of choice for methicillin-resistant Staphylococcus aureus (MRSA) pneumonia with a desired trough concentration of 15 to 20 mg/L. The purpose of this study was to evaluate the initial dosing of vancomycin for MRSA pneumonia in critically ill adult trauma patients. ⋯ A vancomycin regimen of 1 g i.v. every 12 hours in critically ill trauma patients with MRSA pneumonia and normal renal function is unlikely to achieve trough concentrations of 15 to 20 mg/L. Doses of at least 1 g i.v. every 8 hours are needed.
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Pediatr Crit Care Me · Jul 2009
Drug use density in critically ill children and newborns: analysis of various methodologies.
To compare in the pediatric, cardiac, and neonatal intensive care units, three methods of assessing vancomycin and linezolid drug use density by number of: defined daily doses (DDDs), prescribed daily doses, and days of drug use per 100 patient days. ⋯ In critically ill children, drug use density of vancomycin is significantly less when evaluated by the DDD method compared with the prescribed daily dose method, a more appropriate method in children. However, the simplest and most accurate method of assessing drug use density is the number of days of drug use method, which allows comparison of drug use density between different pediatric facilities or clinical units.
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Pediatr. Infect. Dis. J. · May 2009
Current recommended dosing of vancomycin for children with invasive methicillin-resistant Staphylococcus aureus infections is inadequate.
Vancomycin area-under-the-concentration-time-curve (AUC) for 24 hours divided by the minimum inhibitory concentration (MIC) (AUC24/MIC) >400 optimally treats invasive methicillin-resistant Staphylococcus aureus (MRSA) infections in adults. It is unknown whether recommended vancomycin dosing regimens for children achieve this value. ⋯ A vancomycin dose of 40 mg/kg/d in children is unlikely to achieve the recommended pharmacodynamic target of AUC24/MIC >400 for invasive MRSA infections even when MIC is 1.0 microg/mL. A starting dose of 60 mg/kg/d should be used in settings where isolates with MIC of 1.0 are common. Alternatives to vancomycin should strongly be considered for patients with MIC > or =2.0 microg/mL.