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Therapeutic drug monitoring of vancomycin in neurosurgery patients, from trough concentration to area under the curve: a retrospective single center cohort study in a tertiary hospital
OBJECTIVE: To evaluate the effect of therapeutic drug monitoring (TDM) of vancomycin in neurosurgery patients. METHODS: In this retrospective, single-center cohort study, data were collected from patients administered vancomycin after neurosurgery during 2020. Intervention by a pharmacist using an a...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8918743/ https://www.ncbi.nlm.nih.gov/pubmed/35264048 http://dx.doi.org/10.1177/03000605221083242 |
Sumario: | OBJECTIVE: To evaluate the effect of therapeutic drug monitoring (TDM) of vancomycin in neurosurgery patients. METHODS: In this retrospective, single-center cohort study, data were collected from patients administered vancomycin after neurosurgery during 2020. Intervention by a pharmacist using an area under the curve (AUC)-based strategy for TDM of vancomycin was started on 1 July 2020. The trough concentration was monitored previously. Data regarding basic demographics, vancomycin application, and TDM were collected and analyzed. RESULTS: Ninety and 155 samples were included in the non-intervention and intervention groups, respectively. No difference in baseline characteristics was detected. After intervention, the attainment rate of vancomycin TDM was significantly increased from 36.7% to 52.3%. The intervention resulted in an increased daily vancomycin dose (28.9 vs. 26.7 mg/kg/day), a more reasonable sample extraction time (sixth vs. ninth dose), reductions in dose adjustments (37.4% vs. 54.4%) and preventative applications (66.7% vs. 52.3%), and no difference in kidney function impact. The intervention group had a shorter hospital stay. CONCLUSIONS: Intervention by a clinical pharmacist using an AUC-based strategy for vancomycin TDM can provide benefits other than pharmacokinetic attainment in neurosurgery patients. Further prospective multi-center studies are needed to establish standardized intervention measures and evaluation indicators. |
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