Participation of the pharmacist in adjusting vancomycin treatment in a pediatric intensive care unit

• Autores: Dolores Pilar Iturgoyen Fuentes, Margarita Cuervas-Mons Vendrell, S. Martín Prado, I García López, T. Pozas María
• Localización: European journal of clinical pharmacy: atención farmacéutica, ISSN 2385-409X, Vol. 20, Nº. 1, 2018, págs. 45-49
• Idioma: inglés
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• Resumen

  • Objective: In 2011 the Infectious Diseases Society of America (IDSA) introduced a change in the recommendations regarding initial vancomycin dosing in pediatric patients. However, many hospitals continue to prescribe the traditional dosage in their routine practice. A review of the subject is therefore required, with dissemination of these new recommendations. Method: During the two-month rotation period (September-October 2015) an exhaustive literature search was made, and meetings were held in different hospital Departments, including a general meeting for the entire hospital (January 2016), to debate the need for increased initial vancomycin dosing in children. Results: The reference vancomycin therapeutic ranges were modified by the Department of Clinical Analysis. Following the meetings, the clinicians were aware of the importance of pharmacokinetic monitoring and of the fact that traditional dosing is unable to reach therapeutic trough concentrations in the great majority of cases. Conclusion: Most studies demonstrate the need to increase the traditional vancomycin starting dosage in children in order to secure therapeutic trough levels in most patients, and this increment does not imply increased nephrotoxicity. Routine monitoring of the trough concentrations is essential. The presence of the hospital pharmacist in the clinical Departments contributes to treatment optimization and favors safe and rational drug use