Critically Ill Clinical Trial
Official title:
Therapeutic Monitoring of Vancomycin in Critical Ill Patients: a Registry
Vancomycin is a glycopeptide antibiotic that is the first line antibiotics for the treatment of serious gram-positive infections involving methicillin-resistant Staphylococcus aureus (MRSA). Its therapeutic window is narrow, so there is a need to monitor serum vancomycin concentration in clinical practice, especially in the critically ill patients. So far, few studies have investigated the clinical outcomes of the dosage strategy that vancomycin dosage is administered and adjusted individually using PPK and Bayesian methods based on observed concentrations. The objective of this study is to investigate the effectiveness, safety and economics of the vancomycin individualized dosing service provided by pharmacists.
Vancomycin is a glycopeptide antibiotic that is the first line antibiotics for the treatment
of serious gram-positive infections involving methicillin-resistant Staphylococcus aureus
(MRSA). Vancomycin use is associated with several adverse events, including nephrotoxicity
and ototoxicity. Its therapeutic window is narrow, so there is a need to monitor serum
vancomycin concentration in clinical practice, especially in the critically ill patients.
Moreover, the Chinese vancomycin TDM guideline recommended that vancomycin dosage should be
administered and adjusted individually based on population pharmacokinetic(PPK) and Bayesian
methods. However, there is a gap between clinical practice and the guideline. So far, few
studies have investigated the clinical outcomes of the dosage strategy that vancomycin dosage
is administered and adjusted individually using PPK and Bayesian methods. Pharmacists could
provide the vancomycin individualized dosing service by joining the ICU multidisciplinary
team. The objective of this study is to investigate the effectiveness, safety and economics
of the vancomycin individualized dosing service provided by pharmacists.
This is a single-center, ambispective cohort study. Patients from the retrospective and
prospective cohort will be divided into 2 groups by exposure. The exposure is whether
patients received pharmacists' consultation. Patients who meet the inclusion and exclusion
criteria will be included in our registry. As a non-intervention study, these information as
below will be collected: basic demographics, diagnosis, the initial dosage regimen and
adjusted strategy of vancomycin, combined special treatment and outcomes.
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