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Prospective Trial of a Novel Nomogram to Achieve Updated Vancomycin Trough Concentrations

Purpose. To determine if the use of a novel vancomycin nomogram predicts dosing regimens that achieve target trough concentrations equal to or more accurate than dosing regimens calculated using traditional pharmacokinetic calculations, evaluate the incidence of subtherapeutic and supratherapeutic t...

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Autores principales: Wesner, Amber R., Brackbill, Marcia L., Coyle, Larissa L., Kidd, Robert S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3791841/
https://www.ncbi.nlm.nih.gov/pubmed/24163693
http://dx.doi.org/10.1155/2013/839456
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author Wesner, Amber R.
Brackbill, Marcia L.
Coyle, Larissa L.
Kidd, Robert S.
author_facet Wesner, Amber R.
Brackbill, Marcia L.
Coyle, Larissa L.
Kidd, Robert S.
author_sort Wesner, Amber R.
collection PubMed
description Purpose. To determine if the use of a novel vancomycin nomogram predicts dosing regimens that achieve target trough concentrations equal to or more accurate than dosing regimens calculated using traditional pharmacokinetic calculations, evaluate the incidence of subtherapeutic and supratherapeutic troughs, and assess pharmacist's impressions of the nomogram. Methods. Prospective, open-label study in 473 patients who had a new order for vancomycin and were >18 years of age and ≤120 kg. Patients were randomized to the active group, dosed using the nomogram, or to the control group, dosed using traditional pharmacokinetic calculations already in place at our institution. Results. Patients dosed via nomogram were within the appropriate trough range in 44% of cases compared to 33% in the control group (P = 0.014). Vancomycin troughs less than 10 mcg/mL were significantly decreased with the use of nomogram (P = 0.032). Incidence of supratherapeutic troughs, greater than 20 mcg/mL, was not significantly different between groups (P = 0.706), and pharmacists agreed that the nomogram was easy to use and saved their time. Conclusions. A novel vancomycin nomogram was prospectively validated and found to be more effective than traditional pharmacokinetic dosing. The nomogram is being implemented as the standard dosing protocol at our institution.
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spelling pubmed-37918412013-10-27 Prospective Trial of a Novel Nomogram to Achieve Updated Vancomycin Trough Concentrations Wesner, Amber R. Brackbill, Marcia L. Coyle, Larissa L. Kidd, Robert S. Interdiscip Perspect Infect Dis Clinical Study Purpose. To determine if the use of a novel vancomycin nomogram predicts dosing regimens that achieve target trough concentrations equal to or more accurate than dosing regimens calculated using traditional pharmacokinetic calculations, evaluate the incidence of subtherapeutic and supratherapeutic troughs, and assess pharmacist's impressions of the nomogram. Methods. Prospective, open-label study in 473 patients who had a new order for vancomycin and were >18 years of age and ≤120 kg. Patients were randomized to the active group, dosed using the nomogram, or to the control group, dosed using traditional pharmacokinetic calculations already in place at our institution. Results. Patients dosed via nomogram were within the appropriate trough range in 44% of cases compared to 33% in the control group (P = 0.014). Vancomycin troughs less than 10 mcg/mL were significantly decreased with the use of nomogram (P = 0.032). Incidence of supratherapeutic troughs, greater than 20 mcg/mL, was not significantly different between groups (P = 0.706), and pharmacists agreed that the nomogram was easy to use and saved their time. Conclusions. A novel vancomycin nomogram was prospectively validated and found to be more effective than traditional pharmacokinetic dosing. The nomogram is being implemented as the standard dosing protocol at our institution. Hindawi Publishing Corporation 2013 2013-09-12 /pmc/articles/PMC3791841/ /pubmed/24163693 http://dx.doi.org/10.1155/2013/839456 Text en Copyright © 2013 Amber R. Wesner et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
Wesner, Amber R.
Brackbill, Marcia L.
Coyle, Larissa L.
Kidd, Robert S.
Prospective Trial of a Novel Nomogram to Achieve Updated Vancomycin Trough Concentrations
title Prospective Trial of a Novel Nomogram to Achieve Updated Vancomycin Trough Concentrations
title_full Prospective Trial of a Novel Nomogram to Achieve Updated Vancomycin Trough Concentrations
title_fullStr Prospective Trial of a Novel Nomogram to Achieve Updated Vancomycin Trough Concentrations
title_full_unstemmed Prospective Trial of a Novel Nomogram to Achieve Updated Vancomycin Trough Concentrations
title_short Prospective Trial of a Novel Nomogram to Achieve Updated Vancomycin Trough Concentrations
title_sort prospective trial of a novel nomogram to achieve updated vancomycin trough concentrations
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3791841/
https://www.ncbi.nlm.nih.gov/pubmed/24163693
http://dx.doi.org/10.1155/2013/839456
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