Am J Health-Syst Pharm
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Pai, A.
Right arrow Articles by Pai, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Pai, A.
Right arrow Articles by Pai, M.
American Journal of Health-System Pharmacy, Vol 61, Issue 17, 1812-1816
Copyright © 2004 by American Society of Health-System Pharmacists

Articles

Vancomycin dosing in high flux hemodialysis: a limited-sampling algorithm

AB Pai and MP Pai


PURPOSE: The feasibility of using a limited-sampling algorithm for administration of vancomycin for treatment of vascular-access-related bacteremia in outpatient high flux hemodialysis was investigated. METHODS: The original vancomycin-dosing algorithm used at our hemodialysis unit required stat orders for serum vancomycin concentrations before each hemodialysis session to determine the dose of vancomycin to be administered posthemodialysis. Vancomycin concentration data obtained using this original algorithm from January through September 2001 were retrospectively analyzed to determine how many vancomycin concentrations measured 5-20 microg/mL and identify potential clinical predictors of vancomycin removal. RESULTS: A total of 409 serum vancomycin concentrations were drawn during the study period. Ninety-seven percent of concentrations drawn were within 5-20 microg/mL. Twenty-eight patients had data evaluable to determine pharmacokinetic parameters. Mean +/- S.D. vancomycin removal was 39% +/- 13%. Body weight and duration of dialysis alone, blood flow rate, and dialysate flow rate were not predictive of vancomycin removal. Based on these data, a revised algorithm with limited vancomycin sampling data was initiated in December 2002. Retrospective analysis of concentrations obtained and achieved by this algorithm demonstrated a 70% reduction in the number of vancomycin concentration determinations, with 93% of these concentrations within 5-20 microg/mL. The estimated annual cost saving to the hemodialysis unit with the revised algorithm was 7552 dollars. CONCLUSION: A vancomycin-dosing algorithm using limited concentration monitoring for hemodialysis patients achieved comparable vancomycin concentrations to those found with more frequent monitoring and resulted in significant cost savings.
 



This article has been cited by other articles:


Home page
 Nephrol Dial TransplantHome page
R. Zvonar, S. Natarajan, C. Edwards, and V. Roth
Assessment of vancomycin use in chronic haemodialysis patients: room for improvement
Nephrol. Dial. Transplant., November 1, 2008; 23(11): 3690 - 3695.
[Abstract] [Full Text] [PDF]

Home page
 Am J Health Syst PharmHome page
B. S. Crawford, R. F. Largen, T. Walton, and J. J. Doran
Once-weekly vancomycin for patients receiving high-flux hemodialysis
Am. J. Health Syst. Pharm., July 1, 2008; 65(13): 1248 - 1253.
[Abstract] [Full Text] [PDF]

Home page
 Nephrol Dial TransplantHome page
T. Ulinski, G. Deschenes, and A. Bensman
Large-pore haemodialysis membranes: an efficient tool for rapid removal of vancomycin after accidental overdose
Nephrol. Dial. Transplant., July 1, 2005; 20(7): 1517 - 1518.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2004 by the American Society of Health-System Pharmacists.