When should vancomycin trough levels be drawn?
Trough level samples are to be taken approximately 30 minutes before the dose is due. Inpatients with normal renal function, the next dose of vancomycin should be given at the scheduled time before the level is known.
How do I monitor my vancomycin AUC?
The Rodvold method relates patient-specific creatinine clearance (CrCl) to total body clearance of vancomycin (11) and is calculated as follows: AUC = dose/[(CrCl × 0.79) + 15.7] · 0.06, in which dose is the total daily vancomycin dose (mg) and CrCl (mL/min) is calculated via the Cockcroft–Gault equation.
Why do you need to monitor serum levels of vancomycin?
It is important to monitor the level of vancomycin because its effectiveness depends on sustaining blood levels at a minimum concentration for the duration of therapy.
What is a normal vancomycin trough?
Vancomycin trough levels of 15–20 mg/L (area under the curve [AUC]: minimum inhibitory concentration [MIC] ratio ≥400 in most patients if MIC is ≤1 mg/L) are recommended by the Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS) in patients with normal renal function and serious …
What does AUC MIC tell you?
The area under the curve (AUC) over 24 hours/minimum inhibitory concentration (MIC) of ≥ 400 best predicts the efficacy of vancomycin, and a trough vancomycin serum concentration between 15 and 20 mg/L has been shown to achieve an AUC/MIC ≥ 400 when the MIC is ≤ 1 in adult patients.
What if vancomycin trough is high?
Recent guidelines have recommended vancomycin trough levels of 15–20 mg/L for treatment of serious infections caused by methicillin-resistant Staphylococcus aureus (MRSA). However, high trough levels may increase risk of nephrotoxicity and mortality, and high vancomycin trough levels have not been well studied.
How do you monitor vancomycin?
Usually only vancomycin troughs are needed. Random levels may be obtained on patients with poor renal function who only receive intermittent or post-dialysis dosing. At minimum, levels should be obtained for all patients by 72 hours of therapy and at least weekly thereafter.
What is AUC in vancomycin?
Vancomycin Area Under The Curve (AUC) If we look at AUC:MIC, there are two parts, and both are addressed by the vancomycin dosing guidelines. AUC vancomycin dosing represents the total vancomycin concentration in the blood over a period of time, usually over 24 hours.
What is the goal range for AUC MIC in vancomycin patients?
Why would vancomycin trough be high?
Several risk factors have been identified for VIN, which high trough vancomycin level (especially >20 mg/L) or doses (>4 g/day), concomitant use of nephrotoxic agents, prolonged therapy (more than 7 days), and admission to an intensive care unit (especially prolonged stay) are the most common ones (1-4, 14).
Why is vancomycin trough important?
Because the goal is to administer the vancomycin such that a minimally effective concentration is always maintained in the blood, measurement of blood levels is usually timed to reflect the trough and, sometimes peak, to evaluate the adequacy of dosing and clearance of the drug from the body.
Why do we check Vanco trough?
Trough serum vancomycin concentrations are the most accurate and practical method for monitoring efficacy. Traditionally vancomycin was believed to display time-dependent bacterial killing, in which case there is little evidence for the use of target peak concentrations. Similarly, this is not recommended in the TG or the AMH.
How to measure vancomycin trough?
Vancomycin blood levels are drawn at timed intervals to measure drug levels during treatment. Vancomycin has a narrow therapeutic index, which is the ratio between the toxic and effective dose of medication. As soon as vancomycin enters the body, the drug gets distributed throughout, and then the kidneys begin to work to remove it from the body.
What is the normal trough level for vancomycin?
Trough concentrations are recommended for therapeutic monitoring of vancomycin, preferably acquired at steady-state (just before fourth dose). To avoid development of resistance, vancomycin trough levels should remain above 10.0 mcg/mL. Complicated infections require higher target levels, typically 15.0 to 20.0 mcg/mL.
When to check for vancomycin trough level?
Vancomycin levels are taken 1-2 hours pre – dose (trough). Do not wait for the level to come back before giving the dose that is due unless CrCl <20mL/min or specifically instructed to do so by microbiology or pharmacy. The trough level should be between 10-20mg/L. Adult Vancomycin intermittent infusion: Prescribing,