Out With the Old,in With the New: What Rising Pharmacists Need to Know About Vancomycin Therapeutic Drug Monitoring in Adults

Abstract

The goal of this commentary is to provide recent pharmacy school graduates and student pharmacists completing APPEs the essential background for correct vancomycin therapeutic drug monitoring (TDM) in the inpatient setting.

Keywords

drug information infectious disease medication safety pharmacy

Get full access to this article

View all access options for this article.

References

Danielson

Besinque

Clarke

, et al. Essential elements for core required advanced pharmacy practice experiences. Am J Pharm Educ. 2019;83(4):6865. doi:10.5688/ajpe6865.

Entry-Level Competencies Needed for Pharmacy Practice in Hospitals and Health-Systems . ASHP-ACPE Task Force, 2010. https://www.ashp.org/-/media/assets/pharmacy-practice/resource-centers/inpatient-care/entry-level-competencies-needed-for-pharmacy-practice-in-hospitals-and-health-systems.ashx

Levine

. Vancomycin: A history. Clin Infect Dis. 2006;42(Suppl 1):S5-S12. doi:10.1086/491709.

Rybak

Lomaestro

Rotschafer

, et al. Vancomycin therapeutic guidelines: a summary of consensus recommendations from the infectious diseases society of America, the American society of health-system pharmacists, and the society of infectious diseases pharmacists [published correction appears in Clin Infect Dis. 2009 Nov 1;49(9):1465]. Clin Infect Dis. 2009;49(3):325-327. doi:10.1086/600877.

Rybak

Lodise

, et al. Therapeutic monitoring of vancomycin for serious methicillin-resistant staphylococcus aureus infections: A revised consensus guideline and review of the American society of health-system pharmacists, the infectious diseases society by America, the pediatric infectious diseases society, and the society of infectious diseases pharmacists. Am J Health-Syst Pharm. 2020;77:835-864. doi:10.1093/ajhp/zxaa036.

Southwood

Fleming

American Society of Health-System Pharmacists , et al. Half-life, elimination rate, and AUC. Concepts in Clinical Pharmacokinetics. 7th edition. ASHP; 2018.

Lodise

Scheetz

Carreno

Chambers

Fowler

Jr Holland

. Associations between vancomycin exposure and acute kidney injury within the recommended area under the curve therapeutic exposure range among patients with methicillin-resistant staphylococcus aureus bloodstream infections. Open Forum Infect Dis. 2022;9(2):ofab651. doi:10.1093/ofid/ofab651.

Finch

Zasowski

Murray

, et al. A quasi-experiment to study the impact of vancomycin area under the concentration-time curve-guided dosing on vancomycin-associated nephrotoxicity. Antimicrob Agents Chemother 2017;61(12):e01293-17. doi:10.1128/AAC.01293-17.

Aljefri

Avedissian

Rhodes

Postelnick

Nguyen

Scheetz

. Vancomycin area under the curve and acute kidney injury: A meta-analysis. Clin Infect Dis. 2019;69(11):1881-1887. doi:10.1093/cid/ciz051.

10.

Neely

Kato

Youn

, et al. Prospective trial on the use of trough concentration versus area under the curve to determine therapeutic vancomycin dosing. Antimicrob Agents Chemother 2018;62(2):e02042-17. doi:10.1128/AAC.02042-17.

11.

Drennan

Begg

Gardiner

Kirkpatrick

CMJ

Chambers

. The dosing and monitoring of vancomycin: What is the best way forward? Int J Antimicrob Agents. 2019;53(4):401-407. doi:10.1016/j.ijantimicag.2018.12.014.

12.

Arquiette

Kim

. Bayesian-estimated vancomycin area under the curve using a single trough concentration vs 2 concentrations. Am J Health Syst Pharm. 2021;78(18):1663-1664. doi:10.1093/ajhp/zxab233.

13.

Neely

Youn

Jones

, et al.

Are vancomycin trough concentrations adequate for optimal dosing?

Antimicrob Agents Chemother. 2014;58(1):309-316. doi:10.1128/AAC.01653-13.

14.

Kufel

Seabury

Mogle

Beccari

Probst

Steele

. Readiness to implement vancomycin monitoring based on area under the concentration-time curve: A cross-sectional survey of a national health consortium. Am J Health Syst Pharm. 2019;76(12):889-894. doi:10.1093/ajhp/zxz070.