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PKP-008 Assessment of the effectiveness of monitoring vancomycin in patients undergoing haemodialysis
  1. MI Sierra Torres,
  2. A Perez Rodriguez,
  3. MD Toscano Guzman,
  4. MV Gil Navarro,
  5. MA Perez Moreno,
  6. AM Villalba Moreno,
  7. E Montecatine Alonso,
  8. L Poyatos Ruiz,
  9. C Villanueva Bueno,
  10. J González-Bueno
  1. Hospital Universitario Virgen del Rocio, Farmacia Hospitalaria, Seville, Spain

Abstract

Background Vancomycin is an antibiotic against Gram positive bacteria. Vancomycin is useful in treating infections caused by foreign materials, such as catheters used in haemodialysis. It is eliminated mainly through the renal system, so any renal system alteration affects the concentration of vancomycin.

Purpose To assess the effectiveness of vancomycin monitoring in patients undergoing haemodialysis and the effectiveness of the interventions made by the pharmacy service to reach the target concentration.

Materials and methods Patients undergoing haemodialysis whose vancomycin levels had been monitored by the pharmacy service between May 2012 to April 2013 at a tertiary level hospital. The variables collected were: age, sex, weight, residual renal function, type of infection, type of microorganism, target level, type of dialysis membrane, initial dose, recommended dose, trough levels and effectiveness of treatment. The target serum concentration was between 15–20 µg/ml in serious infections, and 10–15 µg/ml in milder cases.

Results 26 patients undergoing haemodialysis were selected but just 24 were included.

15 men and 9 women, with an average age of 62.5 years and weight between 50 and 119 kg. Of all patients, just 10 had residual renal function. 6 patients used a low flow membrane, 8 patients used an intermediate membrane, 6 patients used a high flow membrane and no data were available from 3 patients.

The initial dose varied between 5 mg/kg and 23.8 mg/kg. Recommended doses varied between 0.5–2 g. The target was never reached in 4 patients. The goal was achieved after the initial dose in 4 cases, after <2 recommendations in 2 cases and after <5 recommendations in 6 cases.

Conclusions The infection was eradicated in 86% of cases, and the target concentration was reached in 79% of them. These results justify a broader analysis to establish a treatment guide for vancomycin in patients undergoing haemodialysis.

No conflict of interest.

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