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Improving vancomycin dosing by shifting to AUC

Improving vancomycin dosing by shifting to AUC
30 Aug 2017 Case Study

DoseMe Crunch determines if the current clinical approach of measuring troughs as a surrogate marker for vancomycin efficacy is as effective as measuring AUC. 

The Project

DoseMe Crunch partnered with a prominent Australian teaching hospital to review vancomycin dosing in a retrospective patient cohort. The objective of the review was to determine if the current clinical approach of measuring troughs as a surrogate marker for vancomycin efficacy was as effective as measuring area under the curve (AUC).

The Challenge

In 2013, the US Centre for Disease Control and Prevention assigned vancomycin-resistant enterococcus to a serious threat. Annually in the US there are 66,000 enterococcus infections resulting in 1,300 deaths. With some enterococcus strains resistant to vancomycin there are few to no treatments left1.

Experimental and clinical studies suggest AUC/ MIC ratio (≥ 400) is the best parameter to predict the effectiveness of vancomycin. While most therapeutic guidelines suggest using a trough as a surrogate measure for AUC, more recent research suggests this may not be appropriate. The difficulty faced in calculating AUC is the most common reason a hospital will monitor troughs over AUC.

About DoseMe Crunch

DoseMe Crunch is built on the same algorithms that underpin DoseMe, to analyse retrospective and previously under-utilised sources of patient data to empower health services to understand and optimise medication use, benchmark clinical dosing practices and monitor medication management performance.

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