Vancomycin Therapeutic Drug Monitoring

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Project Status:
Completed
Project Line:
Health Technology Review
Project Sub Line:
Technology Review
Project Number:
HA0006-000

There has been a long-standing controversy as to which method is preferable for the optimal dosing of vancomycin administered IV; i.e., only measuring trough blood levels or calculating the ratio of area under the curve (AUC) over the course of 24 hours to the minimum inhibitory concentration (AUC/MIC). Recently, the 2020 US guidelines on the therapeutic monitoring of vancomycin for serious methicillin-resistant Staphylococcus aureus (MRSA) infections elected to recommend AUC-based method as the preferred approach. As most Canadian hospitals currently use the trough level-based method, implementing the AUC-based approach will require more resources (e.g., staff training, software acquisition). An appraisal of the quality of the 2020 US guidelines will help inform policy decisions in Canadian hospitals regarding the adoption of the AUC-based approach to optimize the dosing of IV vancomycin when treating patients with MRSA infection.