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dc.contributor.authorGunning, H
dc.contributor.authorTaylor, G
dc.contributor.authorSmyth, H
dc.contributor.authorMellotte, G
dc.contributor.authorFennell, J
dc.contributor.authorMurphy, P
dc.contributor.authorLavin, P
dc.contributor.authorWall, C
dc.date.accessioned2016-11-17T12:09:32Z
dc.date.available2016-11-17T12:09:32Z
dc.date.issued2016-10
dc.identifier.urihttp://hdl.handle.net/10147/620924
dc.description.abstractHaemodialysis patients are at risk of gram-positive bacteraemia and commonly require intravenous vancomycin. Intravenously administered vancomycin is primarily excreted by the kidney and exhibits complex pharmacokinetics in haemodialysis patients; achieving therapeutic levels can be challenging. An audit in our unit showed current practises of vancomycin administration resulted in a high proportion of sub-therapeutic levels. A new protocol was developed with fixed weight-based loading and subsequent dosing guided by pre-dialysis levels, target levels were 10-20mg/L. Its effectiveness was prospectively evaluated between 24th September 2012, and 8th February 2013. During this period 25 patients commenced vancomycin, 15 were included. In total, 112 vancomycin levels were taken, 94 (84%) were therapeutic, this was a significant improvement compared to previous practise (odds ratio 5.4, CI 3.1-9.4, p < 0.0001). In conclusion, our study shows this protocol can consistently and reliably achieve therapeutic vancomycin levels
dc.language.isoenen
dc.publisherIrish Medical Journalen
dc.relation.urlhttp://imj.ie/this-months-imj-october-2016-vol-109-number-9/en
dc.subjectKIDNEY DISEASESen
dc.subjectHAEMODIALYSISen
dc.subjectINFECTION CONTROLen
dc.titleAn Approach to Optimise Therapeutic Vancomycin Dosage in a Haemodialysis Populationen
dc.typeArticleen
dc.identifier.journalIrish Medical Journalen
dc.description.fundingNo fundingen
dc.description.provinceLeinsteren
dc.description.peer-reviewpeer-reviewen
html.description.abstractHaemodialysis patients are at risk of gram-positive bacteraemia and commonly require intravenous vancomycin. Intravenously administered vancomycin is primarily excreted by the kidney and exhibits complex pharmacokinetics in haemodialysis patients; achieving therapeutic levels can be challenging. An audit in our unit showed current practises of vancomycin administration resulted in a high proportion of sub-therapeutic levels. A new protocol was developed with fixed weight-based loading and subsequent dosing guided by pre-dialysis levels, target levels were 10-20mg/L. Its effectiveness was prospectively evaluated between 24th September 2012, and 8th February 2013. During this period 25 patients commenced vancomycin, 15 were included. In total, 112 vancomycin levels were taken, 94 (84%) were therapeutic, this was a significant improvement compared to previous practise (odds ratio 5.4, CI 3.1-9.4, p < 0.0001). In conclusion, our study shows this protocol can consistently and reliably achieve therapeutic vancomycin levels


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