Category: Federal Forum Posters
Purpose: Newer evidence supports monitoring of vancomycin based on area under the concentration versus time curve/minimum inhibitory concentration (AUC/MIC), because targeting higher trough concentrations of 15-20 mg/L, as recommended for serious infections per the current vancomycin guidelines, is not needed to achieve AUC/MIC goal of greater than 400. The primary objective is to determine if there is a significant difference between the vancomycin AUC/MIC when calculated based on patient-specific versus population-based parameters in a veteran population. The secondary objective is to determine the impact that patient parameters (weight, age, and creatinine clearance) have on vancomycin patient-specific compared to population-based pharmacokinetic calculations.
Methods: This study is a retrospective chart review of veterans admitted the medical center between January 1, 2006, and December 31, 2008, who received vancomycin and had at least one steady state vancomycin serum peak and trough concentration collected. A maximum of 400 veterans will be included and the following data will be collected using the computerized patient record system (CPRS): name; social security number; patient ward location; date of birth; sex; height; weight; serum creatinine; indication for vancomycin therapy; vancomycin dose, interval, infusion duration; vancomycin trough date, time, value; vancomycin infusion administration dates and times around the collection of vancomycin trough and peak; vancomycin peak date, time, value. The inclusion criteria are veterans who received a scheduled vancomycin regimen, who serum trough concentrations were between 10 – 20 mg/L, and whose peak and trough concentrations were collected at steady state. The exclusion criteria are an acute kidney injury (AKI) or creatinine clearance (CrCl) less than 20 mL/min. For statistical analysis, a p-value of 0.05 or less will be considered statistically significant. If data is continuous a student’s t-test or Mann-Whitney U test will be used, and if data is categorical, a Fisher’s exact or Chi-square test will be used.
Results: Not Applicable
Conclusion: Not Applicable
Madalyn Van Valkenburg– Pharmacy Resident, G.V. (Sonny) Montgomery VA Medical Center, Jackson, MS