ASHP, Infectious Disease Specialists Take New Look At Vancomycin

Main Category: Pharmacy / Pharmacist
Also Included In: Infectious Diseases / Bacteria / Viruses;  MRSA / Drug Resistance
Article Date: 09 Jan 2009 - 8:00 PDT

email to a friend   printer friendly   view / write opinions   rate article

A consensus statement recently published in the January 1, 2009 , issue of the American Journal of Health-System Pharmacy (AJHP), sheds new light on the appropriate use and monitoring of vancomycin in adult patients.

Vancomycin is one of the most-widely used antibiotics for the treatment of serious gram-positive infections involving methicillin-resistant Staphylococcus aureus ( MRSA ). The practice of routine monitoring and adjusting of drug dosages based on serum vancomycin concentrations has been the subject of intense debate for many years.

The statement is the result of a consensus review conducted by member experts from the American Society of Health-System Pharmacists (ASHP), the Infectious Diseases Society of America, and the Society of Infectious Diseases Pharmacists. The panel evaluated the scientific data and controversies associated with serum vancomycin monitoring.

The document offers recommendations based on the scientific evidence, including selection of pharmacokinetic and pharmacodynamic monitoring parameters, dosing strategies, methods for monitoring effectiveness, and strategies for preventing toxicity.

Because of concerns about antibiotic resistance, the statement's advice on dosing to achieve effective drug levels is particularly important, including the recommendation that dosages should be calculated on the patient's actual body weight.

Participating on the expert panel were: Michael Rybak, Pharm.D., MPH (Chair); Ben Lomaestro, Pharm.D.; John C. Rotschafer, Pharm.D.; Robert C. Moellering Jr., M.D.; William Craig, M.D.; Marianne Billeter, Pharm.D.; Joseph R. Dalovisio, M.D.; and Donald P. Levine, M.D.

The document is available online at http://www.ajhp.org/cgi/reprint/66/1/82.

About ASHP

For more than 60 years, ASHP has helped pharmacists who practice in hospitals and health systems improve medication use and enhance patient safety. The Society's 35,000 members include pharmacists and pharmacy technicians who practice in inpatient, outpatient, home-care, and long-term-care settings, as well as pharmacy students. For more information about the wide array of ASHP activities and the many ways in which pharmacists help people make the best use of medicines, visit ASHP's Web site, http://www.ashp.org, or its consumer Web site, http://www.ashp.org.

ASHP