Evaluation of a vancomycin dosing nomogram based on the Modification of Diet in Renal Disease equation in intensive care unit patients

Brandy S. Golenia, Alexander R. Levine, Iman M. Moawad, D. Dante Yeh, Paul A. Arpino

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Purpose: The purpose of the study is to evaluate the effectiveness of a vancomycin nomogram using actual body weight and the Modification of Diet in Renal Disease equation to estimate renal function in intensive care unit patients. Methods: Retrospective evaluation (preimplementation group, n = 57) was conducted from March 2011 to April 2011. Prospective evaluation was conducted after nomogram implementation (postimplementation group, n = 60) from December 2011 to February 2012. Results: The percentage of patients with an initial vancomycin trough concentration 15 μg/mL or higher increased in the postimplementation group as compared with the preimplementation group (72% vs 39%, P = .0004). The postimplementation group also demonstrated an increase in the percentage of patients with initial trough concentration between 15 and 20 μg/mL (42% vs 19%, P = .0099), and no statistical difference in the percentage of patients with an initial trough greater than 20 μg/mL (30% vs 19%, P = .2041). There was no difference in nephrotoxicity in the postimplementation group compared with the preimplementation group (18% vs 17.5%, P = 1.0). Conclusion: Use of a vancomycin nomogram increased the percentage of initial vancomycin trough concentrations 15 μg/mL or higher in intensive care unit patients and was not associated with an increased occurrence of nephrotoxicity.

Original languageEnglish (US)
Pages (from-to)710-716
Number of pages7
JournalJournal of Critical Care
Volume28
Issue number5
DOIs
StatePublished - Oct 2013
Externally publishedYes

Keywords

  • Antibiotics
  • Dosing nomogram
  • ICU
  • Vancomycin

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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