Pharmacy, Health Sciences & Exercise Science
Event Title
Determining an Initial Dosing Recommendation for Vancomycin in Obese Patients
Document Type
Oral Presentation
Location
Indianapolis, IN
Subject Area
Pharmacy, Health Sciences & Exercise Science
Start Date
11-4-2014 10:15 AM
End Date
11-4-2014 11:45 AM
Sponsor
Kendra Atkinson (Butler University)
Description
Background: Studies have shown that obese patients have altered vancomycin pharmacokinetic parameters such as larger volumes of distribution (Vd), lower levels of free drug, and increased creatinine clearance. However, limited data exists regarding specific vancomycin dosing recommendations in obese patients.
Study Objective: The primary objective of this study is to determine vancomycin pharmacokinetic parameters (Vd, k, T1/2) in the obese patient population and formulate initial dosing recommendations for vancomycin in this patient population.
Methods: This is a retrospective observational study which includes patients with a BMI ≥ 30kg/m2, who received vancomycin between October 1, 2012 and March 30, 2014 at Eskenazi Health, and who had a least one set of steady-state vancomycin peak and trough serum concentrations obtained. Reasons for exclusion include < 18 years of age, pregnancy, incarceration, cystic fibrosis, burn injury, hemodialysis, continuous renal replacement therapy, patients at risk for acute kidney injury, and acute kidney injury. The primary outcome for this study is to determine vancomycin pharmacokinetic parameters to develop initial dosing recommendations for vancomycin in the obese patient population. Secondary outcomes include determining the percentage of patients who meet goal serum trough concentrations, have trough concentrations <10mcg/mL or >20mcg/mL, and number of patients requiring dose adjustments. Data regarding clinical outcomes and adverse effects is also evaluated.
Significance: Limited data exists to guide vancomycin dosing in the obese patient population. This study may benefit overall patient care, within this population, in regards to the dosing and monitoring of vancomycin therapy.
Determining an Initial Dosing Recommendation for Vancomycin in Obese Patients
Indianapolis, IN
Background: Studies have shown that obese patients have altered vancomycin pharmacokinetic parameters such as larger volumes of distribution (Vd), lower levels of free drug, and increased creatinine clearance. However, limited data exists regarding specific vancomycin dosing recommendations in obese patients.
Study Objective: The primary objective of this study is to determine vancomycin pharmacokinetic parameters (Vd, k, T1/2) in the obese patient population and formulate initial dosing recommendations for vancomycin in this patient population.
Methods: This is a retrospective observational study which includes patients with a BMI ≥ 30kg/m2, who received vancomycin between October 1, 2012 and March 30, 2014 at Eskenazi Health, and who had a least one set of steady-state vancomycin peak and trough serum concentrations obtained. Reasons for exclusion include < 18 years of age, pregnancy, incarceration, cystic fibrosis, burn injury, hemodialysis, continuous renal replacement therapy, patients at risk for acute kidney injury, and acute kidney injury. The primary outcome for this study is to determine vancomycin pharmacokinetic parameters to develop initial dosing recommendations for vancomycin in the obese patient population. Secondary outcomes include determining the percentage of patients who meet goal serum trough concentrations, have trough concentrations <10mcg/mL or >20mcg/mL, and number of patients requiring dose adjustments. Data regarding clinical outcomes and adverse effects is also evaluated.
Significance: Limited data exists to guide vancomycin dosing in the obese patient population. This study may benefit overall patient care, within this population, in regards to the dosing and monitoring of vancomycin therapy.