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07/29/21 mb Vancomycin ADULT Guideline Update
August 3, 2021
From: "Madeline Belk" <madeline.belk@hhsys.org>
Sent: Thursday, July 29, 2021 8:55:08 AM
Subject: Vancomycin ADULT Guideline Update
HH - Guideline - Vancomycin Dosing 6-11-2021
Good morning Pharmacists,
The update to Huntsville Hospital's Vancomycin Dosing Guideline for ADULT Patients has officially been approved by the ID Subcommittee and the P&T Committee. You may recall hearing about these changes during Huddle a few weeks back, but as a review the changes include the following:
- CNS infections will now be monitored via AUC/MIC (previously trough-based)
- AUC/MIC and trough goals are still 400-600 mg*hr/L and 10-15 mg/L, respectively, but there is now an emphasis on targeting the lower end of the range (example: target < 500 mg*hr/L for AUC monitoring and target 10 mg/L for trough-based monitoring)
- Loading doses (20-25 mg/kg, max 3000 mg) are now only recommended in critically ill patients with severe infections and in patients that require hemodialysis, continuous renal replacement therapy, and peritoneal dialysis (previously a wide range of doses were recommended based on severity of illness)
- The target trough for patients in AKI is now 10-15 mg/L (previously 15-20 mg/L)
- Guidance has been added in regards to vancomycin dosing and monitoring in peritoneal dialysis and ultrafiltration
You can find the updated document attached to this email as well under the "PKS Information" link on FormWeb. Please contact AMT if you have any questions regarding this updated guideline.
Thanks,
Madeline