N/A
N=99
Loading Vancomycin Doses in the Emergency Department
Infectious Disease
Bottom Line
View on ClinicalTrials.gov: NCT01162733 ↗Enrolled (actual)
99
Serious AEs
2.0%
Results posted
Mar 2014
Primary outcome: Primary: Percentage of Participants First Achieving Therapeutic Levels at 36 Hours — 20; 18 percentage of participants
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- Vancomycin (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Christiana Care Health Services
- Primary completion
- Jun 2012
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Percentage of Participants First Achieving Therapeutic Levels at 36 Hours |
20; 18 | — |
| PRIMARY Percentage of Participants First Achieving Therapeutic Levels at 12 Hours |
3; 34 | — |
Summary
In 2008, our ED administered an average of 245 doses of vancomycin per month. Currently there is no consistency in the ED practice in regards to vancomycin dosing. In 2009, the IDSA put forth new recommendations for vancomycin dosing in order to achieve therapeutic levels more rapidly. It has been hypothesized that if therapeutic levels are reached more rapidly then patients will in turn have better clinical outcomes and that the development of resistant organisms will be decreased. Methicillin resistant Staphylococcus aureus (MRSA) has emerged as one of the most deadly pathogens that are currently plaguing our patient population. Vancomycin is one of only a few antibiotics that are effective for treating MRSA. It is imperative that the ED physicians consistently and correctly dose vancomycin in order to give the patients the best chance to fight infection while helping to prevent further resistance in this already highly resistant organism. It is believed this study will reveal that the new dosing recommendations by the IDSA will lead to the achievement of therapeutic levels more rapidly. This information will in turn help to convince ED physicians that a change in current clinical practice is warranted and ultimately lead to better clinically outcomes for the patients.
Eligibility Criteria
Inclusion Criteria
- At least 18 years of age
- Treated in Christiana Emergency Department
- Receiving Vancomycin for an infection or presumed infection
- Being admitted to Christiana Hospital
- Planned continued use of Vancomycin after admission.
Exclusion Criteria
- Less than 18 years of age
- Weight greater than 120 kg.
- Concurrent use of aminoglycosides or acyclovir
- Sepsis patients being admitted to ICU with presumed diagnosis of pneumonia
- Patients currently undergoing dialysis
- Pregnant or breast feeding
- No plan to continue Vancomycin after admission.
- Creatinine clearance less than 50ml/min.
Data sourced from ClinicalTrials.gov (NCT01162733). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.