Optimal Practice for Vancomycin Therapeutic Drug Monitoring: Position Statement From the Anti-infectives Committee of the International Association of Therapeutic Drug Monitoring and Clinical Toxicology

Stephanie E Reuter; Sophie L Stocker; Jan-Willem C Alffenaar; Sara Baldelli; Dario Cattaneo; Graham Jones; Birgit C P Koch; Danijela Kocic; Sumith K Mathew; Mariadelfina Molinaro; Michael Neely; Indy Sandaradura; Deborah J E Marriott

doi:10.1097/FTD.0000000000000944

Optimal Practice for Vancomycin Therapeutic Drug Monitoring: Position Statement From the Anti-infectives Committee of the International Association of Therapeutic Drug Monitoring and Clinical Toxicology

Ther Drug Monit. 2022 Feb 1;44(1):121-132. doi: 10.1097/FTD.0000000000000944.

Authors

Stephanie E Reuter¹, Sophie L Stocker^{2

3

4}, Jan-Willem C Alffenaar^{2

5

6}, Sara Baldelli⁷, Dario Cattaneo⁷, Graham Jones^{4

8}, Birgit C P Koch⁹, Danijela Kocic^{4

8}, Sumith K Mathew¹⁰, Mariadelfina Molinaro¹¹, Michael Neely¹², Indy Sandaradura^{6

13

14

15}, Deborah J E Marriott^{4

16}

Affiliations

¹ UniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia.
² Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
³ Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital, Sydney, Australia.
⁴ St Vincent's Clinical School, Faculty of Medicine, The University of New South Wales, Sydney, Australia.
⁵ Department of Pharmacy, Westmead Hospital, Sydney, Australia.
⁶ Marie Bashir Institute of Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia.
⁷ Unit of Clinical Pharmacology, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy.
⁸ Department of Chemical Pathology and Clinical Pharmacology, SydPath, St Vincent's Hospital, Sydney, Australia.
⁹ Department of Hospital Pharmacy, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
¹⁰ Department of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore, India.
¹¹ Department of Diagnostic Medicine, Clinical and Experimental Pharmacokinetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
¹² Department of Pediatrics, Keck School of Medicine, University of Southern California, and Division of Infectious Diseases, Children's Hospital Los Angeles, Los Angeles, California, Los Angeles, CA.
¹³ Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
¹⁴ Centre for Infectious Diseases and Microbiology, Westmead Hospital, Sydney, Australia.
¹⁵ Institute for Clinical Pathology and Medical Research, NSW Health Pathology, Sydney, Australia; and.
¹⁶ Department of Clinical Microbiology and Infectious Diseases, St Vincent's Hospital, Sydney, Australia.

PMID: 34882107
DOI: 10.1097/FTD.0000000000000944

Abstract

Individualization of vancomycin dosing based on therapeutic drug monitoring (TDM) data is known to improve patient outcomes compared with fixed or empirical dosing strategies. There is increasing evidence to support area-under-the-curve (AUC24)-guided TDM to inform vancomycin dosing decisions for patients receiving therapy for more than 48 hours. It is acknowledged that there may be institutional barriers to the implementation of AUC24-guided dosing, and additional effort is required to enable the transition from trough-based to AUC24-based strategies. Adequate documentation of sampling, correct storage and transport, accurate laboratory analysis, and pertinent data reporting are required to ensure appropriate interpretation of TDM data to guide vancomycin dosing recommendations. Ultimately, TDM data in the clinical context of the patient and their response to treatment should guide vancomycin therapy. Endorsed by the International Association of Therapeutic Drug Monitoring and Clinical Toxicology, the IATDMCT Anti-Infectives Committee, provides recommendations with respect to best clinical practice for vancomycin TDM.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anti-Bacterial Agents
Anti-Infective Agents*
Area Under Curve
Drug Monitoring / methods
Humans
Vancomycin*

Substances

Anti-Bacterial Agents
Anti-Infective Agents
Vancomycin