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Journal de Pharmacie Clinique

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Pharmacokinetic monitoring of continuous vancomycin infusion: efficiency on medicin and surgery adult patients Volume 25, issue 3, Juillet-Août-Septembre 2006

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Service de pharmacie, Centre hospitalier Auban-Moët, rue de l’Hôpital, 51205 Epernay

Vancomycin is a strategic curative antibiotic for bacterial nosocomial or communitarian infections. Efficay and toxicity are linked with blood concentrations, implying a therapeutic drug monitoring. In Auban-Moët Hospital, pharmacists realise optimisation of treatments using a pharmacokinetic population program. Results from a previous retrospective study had conducted us to update the recommendations regarding vancomycin treatments in continuous infusion. A prospective study was set on consecutively to their diffusion. The objectives were to determine if the recommendations were followed and if monitoring was efficient. The study took place in 120 medicine and surgery beds with nominative delivery (January to October 2005). Thirty-two patients were treated. Patients were 70 years old [65-75] and their renal function was decreased. Creatinin clearance was 84 mL/min and 36% presented a renal insufficiency. Patients presented nephrotoxicity risks factors which justified pharmacokinetic drug monitoring. Recommendations on treatment were followed. Vancomycin and creatinin assays frequency was 80% above the expected values. Average blood concentration was 25.0 mg/mL [17.6-28.6], indicating biological efficacy of the treatments. No nephrotoxic incident was found. 11170 € per treated patient was saved. Requirements for monitoring were 108.36 € per patient [79.98-136.74]. Mean benefit for the institution was 1061.74 € per treated patient [855.03-1268.45]. Optimisation of curative treatments with vancomycin in continuous infusion is justified and adapted for targeting population. Pharmacokinetic monitoring is linked with biological efficacy and efficiency to reduce nephrotoxic incidents.