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A REVIEW OF VANCOMYCIN THERAPEUTIC DRUG MONITORING METHODS IN CLINICAL PRACTICE
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Abstract
Vancomycin is an antibiotic indicated in the treatment of severe infections with suspected or confirmed gram-positive cocci, especially methicillin-resistant Staphylococcus aureus. Due to the large variability in pharmacokinetic parameters (e.g.volume of distribution, renal clearance) among individuals, the probability of AUC/MIC target attentment of 400-600 is also very different for each patient using the same vancomycin dosage regimen. Therefore, individualizing vancomycin dose based on therapeutic dose monitoring (TDM) has been a new trend in clinical practice to optimize its effectiveness and safety. There are multiple therapeutic dose monitoring approaches for vancomycin, including TDM based on trough concentration and TDM based on AUC/MIC estimated from trough concentration, from 2 concentrations, or by Bayesian software simulation. Each method has its own advantages and disadvantages in clinical practice. Therefore, the choice of vancomycin TDM method should be considered the clinical context and implementation resources of the treatment units.
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Keywords
Vancomycin, therapeutic dose monitoring, Bayesian
References
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