Assessment of vancomycin utilization among Lebanese hospitals

Abstract

Objectives: To assess the appropriateness of vancomycin dosing and monitoring at Lebanese hospitals. Methods: This was a multicenter retrospective study conducted at 3 Lebanese hospitals between January and March 2018. Patients 18 years of age and older treated with vancomycin for a systemic infection or prophylaxis were eligible for study enrollment. Consistency with the Infectious Diseases Society of America guidelines was evaluated to determine whether the dose of vancomycin was appropriate, as well as for the time of trough measurement, and the target concentration obtained. Results: From a total of 120 patients who met the inclusion criteria, only 11 (12%) were given the appropriate maintenance dose of vancomycin with respect to actual body weight. The trough levels were monitored for 67 (55.8%) patients, with 20 (29.9%) of these patients achieving appropriate therapeutic trough levels of 15-20 mg/l. The trough concentration time measurement before the fourth dose was only carried out in 28 (41.8%) of the 67 patients. Conclusion: This study reveals a gap between the appropriate utilization of vancomycin with respect to the international guidelines in the studied Lebanese hospitals. It highlights the need for dosing and monitoring protocols suitable for vancomycin utilization in these hospitals.

Experience of Vancomycin Therapeutic Drug Monitoring in Two Multidisciplinary Hospitals in Latvia

“…Publications indicate that in critically ill patients, vancomycin concentrations often do not reach therapeutic levels (15-20 mg/L) during the first 5 days of vancomycin therapy [17]. For more successful therapy results, vancomycin concentration should reach therapeutic concentration more rapidly [18]. Malaeb et al (2019) reported that most of the physicians do not administer a loading dose when initiating vancomycin therapy.…”

“…For more successful therapy results, vancomycin concentration should reach therapeutic concentration more rapidly [18]. Malaeb et al (2019) reported that most of the physicians do not administer a loading dose when initiating vancomycin therapy. This could explain why in most of the cases target vancomycin concentration levels cannot be achieved [18].…”

“…Malaeb et al (2019) reported that most of the physicians do not administer a loading dose when initiating vancomycin therapy. This could explain why in most of the cases target vancomycin concentration levels cannot be achieved [18]. In our study in the hospital without a TDM protocol, only two patients (1.59%) received a loading dose according to the medical records.…”