What is a vancomycin nomogram?
What is a vancomycin nomogram?
This integrated nomogram is a tool that clinicians can use in selecting appropriate initial vancomycin regimens on the basis of age and serum creatinine, to achieve high-target levels of 15–20 mg/L. The nomogram should not replace clinical judgment for patients with unstable and/or reduced renal function.
How is vancomycin AUC MIC calculated?
The empiric AUC:MIC ratio for a vancomycin dosing regimen can be predicted in advance by a simple formula: First, divide the total daily dose of vancomycin by the estimated clearance of vancomycin. Then divide this number by the MIC.
Why is AUC used for vancomycin dosing?
AUC vancomycin dosing represents the total vancomycin concentration in the blood over a period of time, usually over 24 hours. In order to calculate this manually: Two vancomycin levels need to be drawn when the patient’s vancomycin is at a stable concentration, usually referred to as steady-state.
What is the goal range for AUC MIC in vancomycin patients?
The area under the curve (AUC) over 24 hours/minimum inhibitory concentration (MIC) of ≥ 400 best predicts the efficacy of vancomycin, and a trough vancomycin serum concentration between 15 and 20 mg/L has been shown to achieve an AUC/MIC ≥ 400 when the MIC is ≤ 1 in adult patients.
How is vancomycin dosed?
Typically 15 to 20 mg/kg every 8 to 12 hours for most patients (based on actual body weight, rounded to the nearest 250 mg increment).
When do you draw Vanco AUC?
Clinical Example of Vancomycin Dosing Using AUC A patient with normal renal function is receiving vancomycin 1 gm IV q12h. A trough is drawn 30 minutes before the fourth dose, the fourth dose is infused over one hour, and the peak is drawn one hour after the infusion is complete.
What does AUC MIC tell you?
Definition: The area under the concentration–time curve over 24 hours in steady-state divided by the MIC value for the same drug. fAUC/MIC refers to the unbound fraction of the drug.
What is toxic level of vancomycin?
It has been described that vancomycin trough plasma levels >20 μg/mL or AUC0–24 h >700 μg/mL*h are related to nephrotoxicity.
How fast should vancomycin be infused?
Vancomycin should be infused slowly in a dilute solution (2.5 to 5.0 mg/ml) at a rate no greater than 10 mg/min and over a period not less than 60 minutes to avoid rapid infusion-related reactions. Stopping the infusion usually results in a prompt cessation of these reactions.
What is area under the curve vancomycin?
The 2020 consensus guidelines for therapeutic monitoring of vancomycin (VAN) recommends a target VAN area under the concentration curve (AUC) of 400–600 mg*hr/L for serious methicillin-resistant Staphylococcus aureus (MRSA) infections, assuming a minimum inhibitory concentration (MIC) of 1 mg/L and no longer recommends …
When should vancomycin peak and trough levels be drawn?
Draw trough specimen immediately before (≤30 min) next dose. Draw peak specimen 1-2 hours after completion of intravenous dosage.
What is the MIC of vancomycin?
In 2006, the Clinical and Laboratory Standards Institute (CLSI) established the vancomycin minimum inhibitory concentration (MIC) susceptibility breakpoint as 2 μg/mL for S. aureus while the definitions of VISA and vancomycin resistant S. aureus (VRSA) changed to MIC of 4 to 8 μg/mL and ≥ 16 μg/mL, respectively (6).
