Evaluation of a Pilot Vancomycin Precision Dosing Advisory Service on Target Exposure Attainment Using an Interrupted Time Series Analysis.
Adult
Anti-Bacterial Agents
/ administration & dosage
Area Under Curve
Australia
Bayes Theorem
Drug Monitoring
/ methods
Female
Humans
Interrupted Time Series Analysis
/ methods
Male
Microbial Sensitivity Tests
/ methods
Middle Aged
Pilot Projects
Precision Medicine
/ methods
Retrospective Studies
Vancomycin
/ administration & dosage
Journal
Clinical pharmacology and therapeutics
ISSN: 1532-6535
Titre abrégé: Clin Pharmacol Ther
Pays: United States
ID NLM: 0372741
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
received:
24
08
2020
accepted:
10
11
2020
pubmed:
16
11
2020
medline:
21
5
2021
entrez:
15
11
2020
Statut:
ppublish
Résumé
This study evaluated the ability of a pilot therapeutic drug monitoring (TDM) Advisory Service to facilitate vancomycin therapeutic target attainment within a real-world clinical setting. The Service provided area under the concentration-time curve (AUC)-guided vancomycin dose recommendations, using Bayesian forecasting software and clinical expertise, to prescribers at an Australian hospital. A retrospective audit of intravenous vancomycin therapy (> 48 hours) in adults (≥ 18 years old) was undertaken over a 54-month period to evaluate attainment of established vancomycin pharmacokinetic/pharmacodynamic targets (AUC over 24 hours / minimum inhibitory concentration: 400-600) before (36-month period) and after (18-month period) Service implementation. Interrupted time series analysis was employed to evaluate monthly measures of the median proportion of therapy spent within the target range. Indices of time to target attainment were also assessed before and after Service implementation. The final cohort comprised 1,142 courses of vancomycin (816 patients); 835 courses (596 patients) and 307 courses (220 patients) administered before and after Service implementation, respectively. Prior to piloting the Service, the median proportion of time in the target range was 40.1% (95% CI, 34.3-46.0%); this increased by 10.4% (95% CI, 1.2-19.6%, P = 0.03) after the Service, and was sustained throughout the post-Service evaluation period. Post-Service target attainment at 48-72 hours after initiation of therapy was increased (7.8%, 95% CI, 1.3-14.3%, P = 0.02). The findings of this study provide evidence that a consultative TDM Service can facilitate attainment of vancomycin therapeutic targets; however, optimization of the Service may further improve the use of vancomycin.
Substances chimiques
Anti-Bacterial Agents
0
Vancomycin
6Q205EH1VU
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
212-221Informations de copyright
© 2020 The Authors. Clinical Pharmacology & Therapeutics © 2020 American Society for Clinical Pharmacology and Therapeutics.
Références
Rybak, M.J. et al. Therapeutic monitoring of vancomycin for serious methicillin-resistant Staphylococcus aureus infections: a revised consensus guideline and review by the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the Society of Infectious Diseases Pharmacists. Am. J. Health Syst. Pharm. 77, 835-864 (2020).
Neely, M.N. et al. Are vancomycin trough concentrations adequate for optimal dosing? Antimicrob. Agents Chemother. 58, 309-316 (2014).
Van Dort, B.A. et al. Education to improve vancomycin use: the perspectives of educators and education recipients. Intern. Med. J. 50, 565-572 (2020).
Mogle, B.T., Steele, J.M., Seabury, R.W., Dang, U.J. & Kufel, W.D. Implementation of a two-point pharmacokinetic AUC-based vancomycin therapeutic drug monitoring approach in patients with methicillin-resistant Staphylococcus aureus bacteraemia. Int. J. Antimicrob. Agents 52, 805-810 (2018).
Álvarez, R., López Cortés, L.E., Molina, J., Cisneros, J.M. & Pachón, J. Optimizing the clinical use of vancomycin. Antimicrob. Agents Chemother. 60, 2601-2609 (2016).
Bel Kamel, A., Bourguignon, L., Marcos, M., Ducher, M. & Goutelle, S. Is trough concentration of vancomycin predictive of the area under the curve? A clinical study in elderly patients. Ther. Drug. Monit. 39, 83-87 (2017).
Patel, N., Pai, M.P., Rodvold, K.A., Lomaestro, B., Drusano, G.L & Lodise, T.P. Vancomycin: we can't get there from here. Clin. Infect. Dis. 52, 969-974 (2011).
Prybylski, J.P. Vancomycin trough concentration as a predictor of clinical outcomes in patients with staphylococcus aureus bacteremia: a meta-analysis of observational studies. Pharmacotherapy 35, 889-898 (2015).
van Hal, S.J., Paterson, D.L. & Lodise, T.P. Systematic review and meta-analysis of vancomycin-induced nephrotoxicity associated with dosing schedules that maintain troughs between 15 and 20 milligrams per liter. Antimicrob. Agents Chemother. 57, 734-744 (2013).
Finch, N.A. et al. A quasi-experiment to study the impact of vancomycin area under the concentration-time curve-guided dosing on vancomycin-associated nephrotoxicity. Antimicrob. Agents Chemother. 61, e01293-17 (2017).
Meng, L. et al. Conversion from vancomycin trough concentration-guided dosing to area under the curve-guided dosing using two sample measurements in adults: implementation at an academic medical center. Pharmacotherapy 39, 433-442 (2019).
Neely, M.N. et al. Prospective trial on the use of trough concentration versus area under the curve to determine therapeutic vancomycin dosing. Antimicrob. Agents Chemother. 62, e02042-17 (2018).
Buelga, D.S., del Mar Fernandez de Gatta, M, Herrera, E.V., Dominguez-Gil, A. & García, M.J. Population pharmacokinetic analysis of vancomycin in patients with hematological malignancies. Antimicrob. Agents Chemother. 49, 4934-4941 (2005).
Turner, R.B. et al. Review and validation of bayesian dose-optimizing software and equations for calculation of the vancomycin area under the curve in critically Ill patients. Pharmacotherapy 38, 1174-1183 (2018).
Donagher, J. & Barras, M.A. Therapeutic drug monitoring: using Bayesian methods to evaluate hospital practice. J. Pharm. Pract. Res. 48, 522-529 (2018).
Carland, J.E. et al. Would they trust it? An exploration of psychosocial and environmental factors affecting prescriber acceptance of computerised dose-recommendation software. Br. J. Clin. Pharmacol. (2020). https://doi.org/10.1111/bcp.14496.
Davis, S.L., Scheetz, M.H., Bosso, J.A., Goff, D.A. & Rybak, M.J. Adherence to the 2009 consensus guidelines for vancomycin dosing and monitoring practices: a cross-sectional survey of U.S. hospitals. Pharmacotherapy 33, 1256-1263 (2013).
Norris, R.L. et al. Current status of therapeutic drug monitoring in Australia and New Zealand: a need for improved assay evaluation, best practice guidelines, and professional development. Ther. Drug Monit. 32, 615-623 (2010).
Avent, M.L. et al. Vancomycin therapeutics and monitoring: a contemporary approach. Intern. Med. J. 43, 110-119 (2013).
Rybak, M. et al. Therapeutic monitoring of vancomycin in adult patients: a consensus review of the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Diseases Pharmacists. Am. J. Health Syst. Pharm. 66, 82-98 (2009).
Koppula, S., Ruben, S., Bangash, F. & Szerlip, H.M. Pitfalls in dosing vancomycin. Am. J. Med. Sci. 349, 137-139 (2015).
Morrison, A.P., Melanson, S.E.F., Carty, M.G., Bates, D.W., Szumita, P.M. & Tanasijevic, M.J. What proportion of vancomycin trough levels are drawn too early? Frequency and impact on clinical actions. Am. J. Clin. Pathol. 137, 472-478 (2012).
Roustit, M. et al. Evaluation of glycopeptide prescription and therapeutic drug monitoring at a university hospital. Scand. J. Infect. Dis. 42, 177-184 (2010).
Traugott, K.A., Maxwell, P.R., Green, K., Frei, C. & Lewis, J.S. II. Effects of therapeutic drug monitoring criteria in a computerized prescriber-order-entry system on the appropriateness of vancomycin level orders. Am. J. Health Syst. Pharm. 68, 347-352 (2011).
Al Za'abi, M., Al Muqbali, J. & Al-Waili, K. Sampling time and indications appropriateness for therapeutically monitored drugs at a teaching university hospital in Oman. Saudi Pharm. J. 23, 458-462 (2015).
Hammond, D.A., Atkinson, L.N., James, T.B., Painter, J.T. & Lusardi, K. Effects of staff education and standardizing dosing and collection times on vancomycin trough appropriateness in ward patients. Pharm. Pract. (Granada) 15, 949 (2017).
Baysari, M., Chan, J., Carland, J., Stocker, S., Moran, M. & Day, R. Usability of reports generated by a computerised dose prediction Software. Stud. Health Technol. Inform. 252, 27-32 (2018).
Levison, M.E. Pharmacodynamics of antibacterial drugs. Infect. Dis. Clin. North Am. 14, 281-291 (2000).
Men, P., Li, H.-B., Zhai, S.-D. & Zhao, R.-S. Association between the AUC0-24/MIC ratio of vancomycin and its clinical effectiveness: a systematic review and meta-analysis. PLoS One 11, e0146224 (2016).
Zasowski, E.J. et al. Identification of vancomycin exposure-toxicity thresholds in hospitalized patients receiving intravenous vancomycin. Antimicrob. Agents Chemother. 62, e01684-17 (2018).
Alvarez, O., Plaza-Plaza, J.C., Ramirez, M., Peralta, A., Amador, C.A. & Amador, R. Pharmacokinetic assessment of vancomycin loading dose in critically Ill patients. Antimicrob. Agents Chemother. 61, e00280-17 (2017).
Drennan, P.G., Begg, E.J., Gardiner, S.J., Kirkpatrick, C.M.J. & Chambers, S.T. The dosing and monitoring of vancomycin: what is the best way forward? Int. J. Antimicrob. Agents 53, 401-407 (2019).
Jumah, M.T.B., Vasoo, S., Menon, S.R., De, P.P., Neely, M. & Teng, C.B. Pharmacokinetic/Pharmacodynamic determinants of vancomycin efficacy in enterococcal bacteremia. Antimicrob. Agents Chemother. 62, e01602-17 (2018).
Shelton, R.C., Cooper, B.R. & Stirman, S.W. The sustainability of evidence-based interventions and practices in public health and health care. Annu. Rev. Public Health 39, 55-76 (2018).
Soumerai, S.B., Starr, D. & Majumdar, S.R. How do you know which health care effectiveness research you can trust? A guide to study design for the perplexed. Prev. Chronic. Dis. 12, E101 (2015).
Derde, L.P.G. et al. Interventions to reduce colonisation and transmission of antimicrobial-resistant bacteria in intensive care units: an interrupted time series study and cluster randomised trial. Lancet Infect. Dis. 14, 31-39 (2014).
Crowley, R.K., Fitzpatrick, F., Solanki, D., Fitzgerald, S., Humphreys, H. & Smyth, E.G. Vancomycin administration: the impact of multidisciplinary interventions. J. Clin. Pathol. 60, 1155-1159 (2007).
Broeker, A. et al. Towards precision dosing of vancomycin: a systematic evaluation of pharmacometric models for Bayesian forecasting. Clin. Microbiol. Infect. 25, 1286.e1-1286.e7 (2019).
Shingde, R.V. et al. Assessing the accuracy of two Bayesian forecasting programs in estimating vancomycin drug exposure. J. Antimicrob. Chemother. 75, 3293-3302 (2020).
Cusumano, J.A., Klinker, K.P., Huttner, A., Luther, M.K., Roberts, J.A. & LaPlante, K.L. Towards precision medicine: therapeutic drug monitoring-guided dosing of vancomycin and beta-lactam antibiotics to maximize effectiveness and minimize toxicity. Am. J. Health Syst. Pharm. 77, 1104-1112 (2020).
Kawamoto, K., Houlihan, C.A., Balas, E.A. & Lobach, D.F. Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success. BMJ 330, 765 (2005).
Miller, K. et al. Interface, information, interaction: a narrative review of design and functional requirements for clinical decision support. J. Am. Med. Inform. Assoc. 25, 585-592 (2018).
Osheroff, J.A., Teich, J.M., Middleton, B., Steen, E.B., Wright, A. & Detmer, D.E. A roadmap for national action on clinical decision support. J. Am. Med. Inform. Assoc. 14, 141-145 (2007).
Cockcroft, D.W. & Gault, M.H. Prediction of creatinine clearance from serum creatinine. Nephron 16, 31-41 (1976).