Approved Hospital Formulary
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Approved Hospital Formulary
1/22/20 jm Vancomycin AUC-Guided Dosing Protocol Follow-up
January 22, 2020
From: "Justin Muklewicz" <justin.muklewicz@hhsys.org>
To: "Pharmacists" <grp_allpharm@hhsys.org>
Sent: Wednesday, January 22, 2020 6:20:24 AM
Subject: Vancomycin AUC-Guided Dosing Protocol Follow-up
Good afternoon team,
This email applies ONLY for pharmacists that dose vancomycin for ADULT patients.
I would like to thank EVERYONE for their continued support of our AUC guided vancomycin dosing protocol! We are ~ 2 months in and I would like to take this moment to check-in with everyone and hear your feedback. Please e-mail me if you have any suggestions to improve the calculator, protocol, or guideline. Please see below observations from the AMT thus far.
Things that are going well:
- Great job including your evaluation of steady state concentrations into your notes when you expect accumulation
- Loading doses are being ordered appropriately and have substantially helped with the accuracy of levels at steady state
- Patient inclusion has been done very well. Everyone is doing a great job noting when renal function is unstable and when trough-guided dosing is more appropriate
- Everyone is asking the AMT great questions on complex cases. Please continue doing this!
- The majority of levels are being timed appropriately between doses
Areas for improvement:
- Please remember to save as PDF once you get two levels. This will help us expedite evaluation of the protocol and ensure continued support of this program
- When verifying discontinue orders for vancomycin, please also discontinue unnecessary vancomycinlevels that are active and waiting to be drawn
- Evaluate whether or not the patient-specific Vd is realistic (typical range 0.4-1 L/kg) when interpreting accuracy of levels
- If dosing intervals are less than a q12h schedule, I encourage communicating the importance of level and dose timing to the bedside nurse because of the narrow window with which to draw levels
Please don't hesitate to reach out if you have any questions. Thank you all for your support of our ASP.
AMT SpectraLink: x50286
Sincerely,
Justin