Doing More With Less: Pragmatic Implementation of Vancomycin Area-Under-the-Curve (AUC) Monitoring
| Autor: | Joanne Huang, Jeannie D. Chan, Zahra Kassamali Escobar, Rupali Jain, Thu D. Nguyen |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
0303 health sciences
medicine.medical_specialty medicine.diagnostic_test 030306 microbiology business.industry Area under the curve 03 medical and health sciences 0302 clinical medicine Therapeutic drug monitoring Medicine Vancomycin Pharmacology (medical) 030212 general & internal medicine business Intensive care medicine medicine.drug |
| Zdroj: | Journal of Pharmacy Practice. 36:10-14 |
| ISSN: | 1531-1937 0897-1900 |
| DOI: | 10.1177/08971900211027271 |
| Popis: | Universal area-under-the-curve (AUC) guided vancomycin therapeutic drug monitoring (TDM) is resource-intensive, cost-prohibitive, and presents a paradigm shift that leaves institutions with the quandary of defining the preferred and most practical method for TDM. We report a step-by-step quality improvement process using 4 plan-do-study-act (PDSA) cycles to provide a framework for development of a hybrid model of trough and AUC-based vancomycin monitoring. We found trough-based monitoring a pragmatic strategy as a first-tier approach when anticipated use is short-term. AUC-guided monitoring was most impactful and cost-effective when reserved for patients with high-risk for nephrotoxicity. We encourage others to consider quality improvement tools to locally adopt AUC-based monitoring. |
| Databáze: | OpenAIRE |
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