Evidence map›Paper›PMID 31692636›Full record

ArticleThe Canadian journal of hospital pharmacy

Validation of a Weight Threshold-Based Vancomycin Dosing Protocol for Patients Undergoing Intermittent Hemodialysis.

Lu Xuan Lisa Sun, Kang-Wei David Liu, Stephanie Lynch, Mielen Mistry, Heather Wise, Eduard Iliescu

Open access · bronzeAbstract read
PubMed Full text at PMC
In one paragraph

Article in The Canadian journal of hospital pharmacy. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.1field-weighted citation impact, top 48% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 2 countries.

Lu Xuan Lisa Sun, PharmD, RPh, ACPR, is a Clinical Pharmacist with Kingston Health Sciences Centre, Kingston, Ontario.
Kang-Wei David Liu, BScPhm, PharmD, RPh, MPH, BCPS, was, at the time of this study, a Clinical Pharmacist (General Medicine) with Kingston Health Sciences Centre, Kingston, Ontario. He is now the Director of Pharmacy at Norfolk General Hospital, Simcoe, Ontario, and West Haldimand General Hospital, Hagersville, Ontario.
Stephanie Lynch, BSc(Pharm), RPh, ACPR, PharmD, BCACP, is a Clinical Pharmacist (Nephrology) with Kingston Health Sciences Centre, Kingston, Ontario.
Mielen Mistry, BScPhm, RPh, ACPR, is a Clinical Pharmacist (General Medicine) with Kingston Health Sciences Centre, Kingston, Ontario.
Heather Wise, BSc(Pharm), RPh, ACPR, is a Clinical Pharmacist (Critical Care/Infectious Diseases) with Kingston Health Sciences Centre, Kingston, Ontario.
Eduard Iliescu, MD, BSc, MSc, FRCPC, FACP, FASN, is the Medical Director Hemodialysis, Kingston Health Sciences Centre and Satellites, Kingston, Ontario. He is also Regional Medical Lead for the South East Local Health Integration Network and the Ontario Renal Network.
Kingston Health Sciences Centre · CAHealth Net · USNorfolk General Hospital · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients receiving intermittent hemodialysis (IHD) are at high risk of acquiring gram-positive infections, which are often treated with IV vancomycin. Despite frequent use of vancomycin in the IHD setting, there is variability in dosing and monitoring practices among clinicians at the study institution. There is also a paucity of evidence regarding optimal vancomycin dosing to achieve target pre-IHD serum concentration.

objectivesThe primary objective was to compare the percentage of treatment courses with a serum vancomycin concentration between 15 and 20 mg/L, measured before the third IHD session, before and after implementation of a weight threshold-based dosing protocol. The secondary objectives were to compare the percentage of treatment courses with a pre-third IHD vancomycin concentration between 10 and 22 mg/L and the number of vancomycin measurements per treatment day, before and after protocol implementation.

methodsThis quasi-experimental, single-centre study included inpatients and outpatients who underwent IHD and received at least 2 IV doses of vancomycin, with vancomycin being measured in an appropriately drawn sample before the third IHD session. Before protocol implementation, vancomycin dosing was at the clinician's discretion (usual care). After protocol implementation, each patient received a loading dose of 1000, 1500, or 2000 mg and a maintenance dose of 500, 750, or 1000 mg, depending on body weight.

resultsThe percentage of treatment courses with a pre-third IHD vancomycin concentration between 15 and 20 mg/L was greater after implementation of the protocol than with usual care, but the difference was nonsignificant (44% [8/18] versus 20% [3/15],

conclusionsAt the study institution, the likelihood of achieving recommended vancomycin concentration increased (relative to previous practice) after implementation of a simplified vancomycin dosing protocol for patients undergoing IHD.

Indexed as

dialysisdosing protocoldrug levelsserum concentrationtherapeutic drug monitoringvancomycin

Identifiers

PMID31692636
PMCPMC6799958
OpenAlexW2981396889

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.