ArticleThe Canadian journal of hospital pharmacy2010
Initial vancomycin dosing recommendations for critically ill patients undergoing continuous venovenous hemodialysis.
Article in The Canadian journal of hospital pharmacy, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Benefits of therapeutic drug monitoring of vancomycin: a systematic review and meta-analysis.PloS one · 2013Pooled it
- Vancomycin therapeutic drug monitoring is associated with reduced toxicity in ICU patients: a MIMIC-IV retrospective study.Scientific reports · 2026Article
- Vancomycin dosing in an obese patient with acute renal failure: A case report and review of literature.World journal of clinical cases · 2022Article
- Does the cytokine adsorber CytoSorbAnnals of intensive care · 2022Article
- Optimizing Antimicrobial Dosing for Critically Ill Patients with MRSA Infections: A New Paradigm for Improving Efficacy during Continuous Renal Replacement Therapy.Pharmaceutics · 2022Article
- Recommendation of Antimicrobial Dosing Optimization During Continuous Renal Replacement Therapy.Frontiers in pharmacology · 2020Review
- Vancomycin therapeutic drug monitoring and population pharmacokinetic models in special patient subpopulations.Pharmacology research & perspectives · 2018Article
- Presence and accuracy of drug dosage recommendations for continuous renal replacement therapy in tertiary drug information references.The Canadian journal of hospital pharmacy · 2012Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDelaying appropriate antimicrobial therapy for critically ill patients increases the risk of death. Currently, there are insufficient data to guide initial vancomycin dosing for patients undergoing continuous venovenous hemodialysis (CVVHD).
objectiveTo develop practical recommendations for initial dosing of vancomycin, based on the pharmacokinetics of this drug in critically ill patients undergoing CVVHD.
methodsA chart review was conducted for 24 critically ill adult patients who had undergone concurrent CVVHD and vancomycin therapy. Mean pharmacokinetic parameters were determined, along with practical recommendations for initial vancomycin dosing that targeted steady-state trough concentrations for patients receiving intermittent infusions and steady-state levels for those receiving continuous infusions between 15 and 20 mg/L. Monte Carlo simulation was used to develop the initial vancomycin dosing recommendations.
resultsThe mean (95% confidence interval) pharmacokinetic parameters for vancomycin (elimination rate constant 0.0315 [0.0254-0.0391], half-life 22.0 h [17.72-27.24 h], volume of distribution 0.96 L/kg [0.77-1.20 L/kg], and clearance 2.4 L/h [1.97-2.92 L/h]) indicated that initial intermittent IV dosing of 1.25-1.5 g q24h or 15 mg/kg q24h would be suitable. For continuous infusion, a 1.5-g IV loading dose followed by continuous infusion of 1-1.5 g IV over 24 h (42-62 mg/h) would be recommended. However, Monte Carlo simulation revealed that the probability of achieving desired concentrations between 15 and 20 mg/L with any of these initial regimens is low.
conclusionsThere was considerable variation in vancomycin pharmacokinetics in this patient population. The observations reported here raise concerns about the reliability of numerous empiric dosing recommendations derived from small pharmacokinetic studies in heterogeneous populations. Follow-up therapeutic drug monitoring is essential to ensure that concentrations remain within the target range.
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Registered trials
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