Evaluation of a Pharmacy Directed Vancomycin and Monitoring Pilot Program at an Academic Pediatric Hospital

Lee, Philip; Mason, Carly; Ahmad-Hossain, Haniyyah; Lam, Ka Yi; Germain, Ellen; Munjal, Iona

doi:10.1093/ofid/ofw172.1471

Cited by 1 publication

(4 citation statements)

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“…The earliest study included was published in 1994, 5 and the latest was published in 2020 43 . In the study population, 1 study was for paediatrics, 35 1 was for children 36 and the remaining 32 studies were for adult patients. Characteristics of the included studies were summarized in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…Inappropriate vancomycin TDM may lead to repeated vancomycin troughs and inappropriate interpretation of results, thereby further contribute to unnecessary medical cost 50 . In the standard care model, physicians were responsible for vancomycin TDM and subsequent dose adjustments 5,9,11,14,19,22,30,35,36,43 . Subgroup analysis (control group receiving standard care) showed that compared with the physician‐driven vancomycin model, pharmacist intervention improved the accuracy and timeliness of vancomycin TDM, and achieved a higher rate of attaining concentration in target range in a shorter time (data not shown, see Table S4).…”

Section: Discussionmentioning

confidence: 99%

“…50 In the standard care model, physicians were responsible for vancomycin TDM and subsequent dose adjustments. 5,9,11,14,19,22,30,35,36,43 Subgroup analysis (control group receiving standard care) showed that compared with the physician-driven vancomycin model, pharmacist intervention improved the accuracy and timeliness of vancomycin TDM, and achieved a higher rate of attaining concentration in target range in a shorter time (data not shown, see Table S4). Pharmacists have specialty training in pharmacokinetics and pharmacodynamics, thus have professional advantages in the management of medications with complex dosing and monitoring requirements.…”

Section: Therapeutic Drug Monitoring Managementmentioning

confidence: 99%

“…We screened 1744 titles and abstracts and reviewed 115 full-text studies, of which 34 studies were included in this meta-analysis. Of these, 22 studies were published articles [5][6][7][8][9][10][11][12][13][14][18][19][20][21][25][26][27][28][29][30][31][32] and 12 were abstracts from conference proceedings 22,[33][34][35][36][37][38][39][40][41][42][43] (Figure 1). The earliest study included was published in 1994, 5 and the latest was published in 2020.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

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Impact of pharmacist intervention in reducing vancomycin‐associated acute kidney injury: A systematic review and meta‐analysis

Pan¹,

Jiang

Qian³

et al. 2022

Brit J Clinical Pharma

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Aims The aim was to quantify the relationship between pharmacist intervention and vancomycin‐associated acute kidney injury (AKI). Methods Electronic databases were searched up to August 2020 for meta‐analyses of cohort studies and/or randomized controlled trials. Studies that compared the incidence of AKI in patients between post‐ and prepharmacist intervention were investigated. The primary outcome was incidence of AKI. We also evaluated the influence of pharmacist intervention in risk factors of vancomycin‐associated AKI. Results The search strategy retrieved 1744 studies and 34 studies with 19 298 participants were included (22 published articles and 12 abstracts from conference proceedings). Compared with the preintervention group, the postintervention group patients had a significantly lower incidence of vancomycin‐associated AKI: 7.3% for post‐ and 9.6% for preintervention (odds ratio [OR] 0.52, 95% confidence interval [CI]; 0.41, 0.67], P < .00001). The rate of attaining target concentration was significantly higher in the post‐ than preintervention group (OR 2.86, 95% CI [2.23, 3.67], P < .00001). The postintervention group significantly improved the percentage of serum creatinine laboratory tests than preintervention group (OR = 3.24, 95% CI 2.02, 5.19], P < .00001). Patients postintervention had markedly lower risk of mortality than preintervention patients (OR 0.47, 95% CI [0.31, 0.72], P = .0004). Conclusion Pharmacist intervention in vancomycin treatment significantly decreased the rate of vancomycin‐associated AKI, while improving efficacy and reducing mortality. We speculate that this is because the pharmacist interventions optimized the rationality of vancomycin therapy, monitoring of vancomycin trough concentration and the monitoring of patients' renal function.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%