{"id":4053,"date":"2019-06-01T04:03:11","date_gmt":"2019-05-31T18:03:11","guid":{"rendered":"https:\/\/doseme-rx.com\/?p=4053"},"modified":"2021-04-13T10:40:50","modified_gmt":"2021-04-13T00:40:50","slug":"upcoming-dosing-guidelines","status":"publish","type":"post","link":"https:\/\/doseme-rx.com\/de\/vancomycin\/articles\/upcoming-dosing-guidelines","title":{"rendered":"Vancomycin Dosing Therapeutic Guideline 2019: What\u2019s Changing?"},"content":{"rendered":"\n<p><strong data-rich-text-format-boundary=\"true\">Note: The new&nbsp;<a href=\"https:\/\/doseme-rx.com\/news\/20200401-vancomycin-dosing-guidelines-2020-clinical-summary\">vancomycin dosing guidelines<\/a>&nbsp;have been officially released. Learn what&#8217;s changed and how they&#8217;ll impact you by reading our guide to the&nbsp;<a href=\"https:\/\/doseme-rx.com\/news\/20200330-vancomycin-dosing-guidelines-what-to-know\">new vancomycin dosing changes&nbsp;here<\/a>.<\/strong><\/p>\n\n\n\n<p><span style=\"font-weight: 400;\">The draft of the <\/span><a href=\"https:\/\/www.ashp.org\/-\/media\/assets\/policy-guidelines\/docs\/draft-guidelines\/draft-guidelines-ASHP-IDSA-PIDS-SIDP-therapeutic-vancomycin.ashx?la=en&amp;hash=8126CEE49F401CDEE5DB49712225F0A4518DB94B&amp;fbclid=IwAR0tgq_SfaBvgdRLOeb-y1umK2P2ROLwnJ-RMzSoY5iFSTVn-FeAhfSonoA\"><span style=\"font-weight: 400;\">revised vancomycin therapeutic guidelines<\/span><\/a><span style=\"font-weight: 400;\"> by Rybak et al. for the Infectious Diseases Society of America (and the ASHP, PIDS, and SIDP) are now available for public comment.<\/span><\/p>\n\n\n\n<p><span style=\"font-weight: 400;\">The update, as many expected, recommends moving away from trough targets to AUC24:MIC for the monitoring of vancomycin. Although trough-only therapeutic monitoring for vancomycin is widely used today in clinical practice due to the ease of use, these guidelines present AUC24\/MIC to be the most appropriate pharmacokinetic\/pharmacodynamic target for vancomycin.<\/span><\/p>\n\n\n\n<p><span style=\"font-weight: 400;\">This shift, in part, may have been promoted due to recent studies that have demonstrated there is significant nephrotoxicity risk when targeting higher vancomycin trough concentrations. The research suggests for many patients, an effective AUC24:MIC target of 400-600 mg.h\/L can be achieved with significantly lower trough concentrations than previously recommended.<\/span><\/p>\n\n\n\n<p><span style=\"font-weight: 400;\">Highlights:<\/span><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">An AUC24 of 400-600 mg.h\/L is the recommended target to \u201cachieve clinical efficacy while improving patient safety&#8220;. Trough targets are &#8222;no longer recommended for patients with serious infections due to MRSA&#8220;.<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">AUC is the driver of effectiveness and the risk of acute kidney injury (AKI) is related to trough concentration.<\/span><\/li><li style=\"font-weight: 400;\"><a href=\"https:\/\/doseme-rx.com\/science-behind-doseme\"><span style=\"font-weight: 400;\">Bayesian dosing<\/span><\/a><span style=\"font-weight: 400;\"> is the recommended method for dosing vancomycin. Bayesian dosing is <\/span><a href=\"https:\/\/doseme-rx.com\/benefits\"><span style=\"font-weight: 400;\">shown<\/span><\/a><span style=\"font-weight: 400;\"> in the guidelines to require only half the levels of other manual approaches. \u201cBayesian programs offer numerous advantages over traditional first-order software&#8230;&#8220;<\/span><\/li><li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Acute kidney injury occurs in between 5-43% of patients, with an attributable risk to vancomycin of 59%. Even mild AKI can \u201csignificantly decrease long-term survival rates, increase morbidity, prolong hospitalizations, and escalate healthcare costs.\u201d<\/span><\/li><\/ul>\n\n\n\n<div class=\"wp-block-group alignfull\"><div class=\"wp-block-group__inner-container is-layout-flow wp-block-group-is-layout-flow\">\n<div style=\"height:50px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<div class=\"wp-block-cover alignfull has-background-dim has-background-gradient has-purple-gradient-background landing-cover--graph-underlay\" style=\"min-height:430px;aspect-ratio:unset;\"><div class=\"wp-block-cover__inner-container is-layout-flow wp-block-cover-is-layout-flow\">\n<h2 class=\"has-text-align-center has-white-color has-text-color wp-block-heading\">Vancomycin AUC Conversion Toolkit<\/h2>\n\n\n\n<p class=\"has-text-align-center\">Get instant access to our concise range of free checklists, tips and templates to support you in successfully transitioning to an AUC-based dosing strategy.<\/p>\n\n\n\n<div class=\"wp-block-buttons is-content-justification-center is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button is-style-outline is-style-outline--1\"><a class=\"wp-block-button__link has-white-color has-text-color\" href=\"https:\/\/doseme-rx.com\/vancomycin-auc-conversion-toolkit\">EXPLORE NOW<\/a><\/div>\n<\/div>\n\n\n\n<p><\/p>\n<\/div><\/div>\n\n\n\n<div style=\"height:50px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n<\/div><\/div>\n\n\n\n<p><span style=\"font-weight: 400;\">When managing vancomycin therapy for diverse cohorts including obese and hemodialysis, it is recognized that there is significant pharmacokinetic variability both between and within these groups. The recommendations for use of Bayesian dosing for individualized dosing in these cohorts is also discussed at length in these guidelines.<\/span><\/p>\n\n\n\n<p><strong>Calculating Area Under the Curve &#8211; Pharmacokinetics Refresher<\/strong><\/p>\n\n\n\n<p>Understanding some pharmacokinetics is important to understand how monitoring can be performed for dosing to an Area Under the Curve (AUC) target. Some terms to be familiar with in order to understand the concept of AUC are:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Half-life (t1\/2): The time needed for half of the amount of drug present in the bloodstream to be removed. The half-life will be different for each drug depending on how fast it\u2019s eliminated from the body.<\/li><li>C<sub>max<\/sub>: The peak concentration of drug.<\/li><li>C<sub>min<\/sub>: The trough concentration of drug.<\/li><li>AUC: The <a href=\"http:\/\/www.thebody.com\/content\/art875.html\">Area Under the Curve <\/a>is defined as the total amount of drug that is in the bloodstream over a period of time. Literally, it is the area under the curve between two points on the plot (for mathematicians, the definite integral of the concentration-time profile). It is sometimes described as \u201ctotal exposure to the drug\u201d within a certain time-window.<\/li><li>Steady-state: When the rate of drug intake matches drug elimination. I.e. a consistent amount of the target drug in the bloodstream remains even though dosing continues. This occurs after a certain period of time dependent on the drug and patient. The peaks and troughs will look similar when steady state has been reached &#8211; typically after 4 to 5 half-lives.<\/li><\/ul>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"alignleft\"><img decoding=\"async\" width=\"512\" height=\"300\" src=\"https:\/\/doseme-rx.com\/wp-content\/uploads\/2019\/05\/VancoGuidelineBlog-graph-e1558118332191.png\" alt=\"Vancomycin dosing new therapeutic guidelines 2019\" class=\"wp-image-4054\"\/><\/figure><\/div>\n\n\n\n<p class=\"Default\"><span lang=\"EN-US\">The <\/span><span class=\"Hyperlink0\"><span lang=\"EN-US\"><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/11420333\">minimum inhibitory concentration (MIC)<\/a><\/span><\/span><span lang=\"EN-US\">is the minimum amount (dose) of the antimicrobial drug needed to inhibit the visible growth of bacteria. There are different values for MIC depending on what type of antibacterial drug you use and how resistant a bacteria is to a specific antimicrobial drug. For example, a MIC=1mg\/L indicates that the visible growth of bacteria is inhibited from 1mg\/L of the drug. Typically, the AUC will have to be divided by the MIC (known as AUC\/MIC ratio) to take into account how much of the drug is needed over a period of time (the AUC) to inhibit a certain bacteria 100 percent.<\/span><\/p>\n\n\n\n<p class=\"Default\"><span lang=\"EN-US\">All of these concepts permit the calculation of AUC by hand using a set of formulae. Unfortunately, as one might expect, this is a rather lengthy process. A recent publication by Meng <span class=\"None\"><i>et al.<\/i><\/span>(2019) developed and implemented an abbreviated calculation version that still had 15 separate steps with multiple drug levels!<\/span><\/p>\n\n\n\n<p class=\"Default\"><span lang=\"EN-US\">Problematically, however, most hand-calculation methods assume that the patient is already at steady-state. This has the consequence whereby if one calculates dose adjustments manually, levels cannot be taken to permit this to be done until day 3 of therapy at the earliest. Even more problematically, the guidelines recommend that \u201ctargeted AUC exposures be achieved early within the course of therapy, preferably within the first 24 to 48 hours\u201d.<\/span><\/p>\n\n\n\n<p class=\"Default\"><b><span lang=\"EN-US\">Vancomycin dosing and monitoring AUC &#8211; Wait until Steady-state?<\/span><\/b><b><\/b><\/p>\n\n\n\n<p class=\"Default\"><span lang=\"EN-US\">One of the major benefits of Bayesian dosing indicated by the revised guidelines is Bayesian dosing \u201cdoesn\u2019t require steady-state vancomycin concentrations to allow to early assessment of AUC target attainment\u201d.<\/span><\/p>\n\n\n\n<p class=\"Default\"><span lang=\"EN-US\">In other words, if you use Bayesian dosing, you can take a single level after the first dose is administered, and dose adjust immediately. While this method requires software, it is obviously much faster to calculate (e.g. than the 15-step \u2018<\/span><span lang=\"IT\">abbreviated<\/span><span lang=\"EN-US\">\u2019 method), and quicker to adjust for the patient.<\/span><\/p>\n\n\n\n<p class=\"Default\"><span lang=\"EN-US\">Bayesian dosing is also noted to be effective from a single level, although multiple levels (one shortly after the end of infusion, and one at the end of the dosing interval) is a preferred option if possible.<\/span><\/p>\n\n\n\n<p class=\"Default\"><b><span lang=\"EN-US\">Hang on, what about the MIC part in \u201cAUC24:MIC\u201d?<\/span><\/b><b><\/b><\/p>\n\n\n\n<p class=\"Default\"><span lang=\"EN-US\">Typically, most centers will take approximately three days to return microbiology results, including the MIC. So what approach do the new <\/span><span class=\"Hyperlink0\"><span lang=\"EN-US\"><a href=\"https:\/\/www.ashp.org\/-\/media\/assets\/policy-guidelines\/docs\/draft-guidelines\/draft-guidelines-ASHP-IDSA-PIDS-SIDP-therapeutic-vancomycin.ashx?la=en&amp;hash=8126CEE49F401CDEE5DB49712225F0A4518DB94B&amp;fbclid=IwAR0tgq_SfaBvgdRLOeb-y1umK2P2ROLwnJ-RMzSoY5iFSTVn-FeAhfSonoA\">2019 guidelines<\/a> <\/span><\/span><span lang=\"EN-US\">suggest until then?<\/span><\/p>\n\n\n\n<p class=\"Default\"><span lang=\"EN-US\">Of course, an AUC for vancomycin depends on the bacteria that\u2019s being treated. Given vancomycin\u2019s common use, it is noted in the guidelines that \u201cit is important to be aware of local and national vancomycin susceptibility patterns for MRSA\u201d. That point made, for methicillin resistant staphylococcus aureus (MRSA) it is also noted that vancomycin MICs have remained constant over time, with \u226590% of isolates having MIC &lt; 1mg\/L.<\/span><\/p>\n\n\n\n<p class=\"Default\"><span lang=\"EN-US\">Given this, the guidelines suggest that an appropriate level of AUC over 24 hours should be 400-600 mg*hr\/L with an assumed minimum inhibitory concentration of 1 mg\/L if this is not yet known.<\/span><\/p>\n\n\n\n<p class=\"Default\"><span lang=\"EN-US\">For those interested in the laboratory side, the MIC method cited in the new guidelines is broth micro-dilution (BMD). The discussion around the variance between BMD results and ETests on page 10 of the draft <\/span><span class=\"Hyperlink0\"><span lang=\"EN-US\"><a href=\"https:\/\/www.ashp.org\/-\/media\/assets\/policy-guidelines\/docs\/draft-guidelines\/draft-guidelines-ASHP-IDSA-PIDS-SIDP-therapeutic-vancomycin.ashx?la=en&amp;hash=8126CEE49F401CDEE5DB49712225F0A4518DB94B&amp;fbclid=IwAR0tgq_SfaBvgdRLOeb-y1umK2P2ROLwnJ-RMzSoY5iFSTVn-FeAhfSonoA\">2019 guidelines<\/a> <\/span><\/span><span lang=\"EN-US\">is worthwhile considering.<\/span><\/p>\n\n\n\n<p class=\"Default\"><b><span lang=\"EN-US\">The Impact of AUC on Vancomycin Dosing<\/span><\/b><b><\/b><\/p>\n\n\n\n<p class=\"Default\"><span lang=\"EN-US\">Moving away from a single lab-reported number in a range (trough) to using a calculated number (AUC) instead may appear somewhat challenging at first glance. That said, the guidelines do provide for flexibility &#8211; for example, noting that while two levels on a single dose are optimal, using Bayesian software permits the use of a single trough level &#8211; i.e. no nursing or phlebotomy workflow changes required.<\/span><\/p>\n\n\n\n<p class=\"Default\"><span lang=\"EN-US\">One of the key benefits of DoseMeRx (our Bayesian dosing platform) is that it is configured to match each hospital\u2019s protocols and requirements. DoseMeRx is used to dose vancomycin to both trough and AUC-based targets. <\/span><\/p>\n\n\n\n<p class=\"Default\"><span lang=\"EN-US\">Regardless of your plans for uptake of the new vancomycin guidelines, it can support your dosing protocol. For example, many of our customers have DoseMeRx configured to dose to trough now, but also display AUC24 side-by-side &#8211; preparing and familiarizing their pharmacy staff for a future rollout of AUC-based vancomycin dosing.<\/span><\/p>\n\n\n\n<p><b>Learn more<\/b><\/p>\n\n\n\n<p>Read more on <a href=\"https:\/\/doseme-rx.com\/vancomycin-dosing\">vancomycin dosing and AUC calculations<\/a> using our bayesian dosing calculator. You can also learn about <a href=\"https:\/\/doseme-rx.com\/news\/20191119-vancomycin-trough-level-recommendations\">vancomycin trough levels here<\/a>.<\/p>\n\n\n\n<p><b>Sources<\/b><\/p>\n\n\n\n<ol class=\"wp-block-list\"><li><span style=\"font-weight: 400;\">Rybak, MJ. Le J Lodise LP; et al.<\/span><a href=\"https:\/\/www.ashp.org\/-\/media\/assets\/policy-guidelines\/docs\/draft-guidelines\/draft-guidelines-ASHP-IDSA-PIDS-SIDP-therapeutic-vancomycin.ashx?la=en&amp;hash=8126CEE49F401CDEE5DB49712225F0A4518DB94B&amp;fbclid=IwAR0tgq_SfaBvgdRLOeb-y1umK2P2ROLwnJ-RMzSoY5iFSTVn-FeAhfSonoA\"><span style=\"font-weight: 400;\"> \u201cTherapeutic Monitoring of Vancomycin: A Revised Consensus Guideline.\u201d<\/span><\/a><span style=\"font-weight: 400;\">. <\/span><\/li><li><span style=\"font-weight: 400;\">Doogue, Matthew. Polasek Thomas. Therapeutic Advances in Drug Safety. <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4110820\/\"><span style=\"font-weight: 400;\">\u201cThe ABCD of Clinical Pharmacokinetics.\u201d<\/span><\/a><span style=\"font-weight: 400;\"> Published February 2013.<\/span><\/li><li><span style=\"font-weight: 400;\">Andrews, JM. Determination of minimum inhibitory concentrations. Published Jul 2001<\/span><\/li><li><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/11420333\"><span style=\"font-weight: 400;\">https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/11420333<\/span><\/a><\/li><li><span style=\"font-weight: 400;\">Anderson, Peter. TheBody. <\/span><a href=\"http:\/\/www.thebody.com\/content\/art875.html\"><span style=\"font-weight: 400;\">The ABCs of Pharmacokinetics<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/li><li><span style=\"font-weight: 400;\">Holmes, Natasha.Turnidge John. Munckhof Wendy; et,al. American Society for Microbiology. <\/span><a href=\"https:\/\/aac.asm.org\/content\/57\/4\/1654#ref-23\"><span style=\"font-weight: 400;\">\u201cVancomycin AUC\/MIC Ratio and 30-Day Mortality in Patients with <\/span><i><span style=\"font-weight: 400;\">Staphylococcus aureus<\/span><\/i><span style=\"font-weight: 400;\"> Bacteremia.\u201d<\/span><\/a><\/li><li><span style=\"font-weight: 400;\">University Health System. <\/span><a href=\"https:\/\/www.universityhealthsystem.com\/~\/media\/files\/clinical-pathways\/vancomycin-dosing-guidelines-adults-2018.pdf?la=en\"><span style=\"font-weight: 400;\">\u201cVancomycin Dosing for Adults.\u201d<\/span><\/a><\/li><li><span style=\"font-weight: 400;\">American Journal of Health System Pharmacists. \u201cTherapeutic Monitoring of Vancomycin in Adult Patients: <\/span><a href=\"https:\/\/www.ashp.org\/-\/media\/assets\/policy-guidelines\/docs\/therapeutic-position-statements\/therapeutic-monitoring-vancomycin-adults.ashx?la=en&amp;hash=CB26F91854B386F99E04D1DAF340019794AD860C\"><span style=\"font-weight: 400;\">\u201cA Consensus Review of the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Diseases Pharmacists.\u201d<\/span><\/a><span style=\"font-weight: 400;\"> Published 2009<\/span><\/li><li><span style=\"font-weight: 400;\">Czosnowski,Quinn. Miano Todd. Clingate. <\/span><a href=\"https:\/\/clinicalgate.com\/principles-of-drug-dosing-in-critically-ill-patients\/\"><span style=\"font-weight: 400;\">\u201c<\/span><span style=\"font-weight: 400;\">Principles of Drug Dosing in Critically Ill Patients.\u201d<\/span><\/a><\/li><\/ol>\n\n\n<div class=\"trial-form-module form_row\" id=\"bookademo\">\r\n    \r\n<div class=\"copy\">\r\n\t<h2 class=\"has-gold-color has-text-color\">Demo anfordern<\/h2>\r\n\t<p>Sehen Sie, wie einfach DoseMeRx zu bedienen und in Ihren Arbeitsalltag zu integrieren ist.<\/p>\n<p>Fordern Sie unten eine Demo an. Sie k\u00f6nnen uns auch anrufen unter +1 (832) 358-3308 oder eine E-Mail an <a href=\"mailto:hello@dosemehealth.com\">hello@dosemehealth.com<\/a> senden.<\/p>\n<\/div>\t\t\r\n\r\n<script>\r\n\t$(function () {\r\n\t\t\r\n\t\t\r\n\t$.getJSON(\"https:\/\/api.ipstack.com\/check?access_key=2096fae20ea80a0c432c80c876bb462d&output=json\").done(function(e) {\r\n\t\t$(\"#input_11_7\").val(e.ip);\t\t\t\t\r\n\t\t$(\"#input_11_8\").val(e.city + \", \" + e.region_name + \", \" + e.country_name);\r\n\t\t$(\"#input_11_10\").val(e.country_name);\r\n\t\t$(\"#input_11_15\").val(e.continent_name);\r\n\t})\t\t\t\r\n\r\n\t});\r\n\r\n\r\n\t<\/script>\r\n\r\n<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar 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><label class='gfield_label gform-field-label' for='input_11_5'>E-Mail<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_5' id='input_11_5' type='email' value='' class='large'   placeholder='E-Mail *' aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_11_1\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_1'>Vorname<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_1' id='input_11_1' type='text' value='' class='large'    placeholder='Vorname *' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_9\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_9'>Nachname<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_9' id='input_11_9' type='text' value='' class='large'    placeholder='Nachname *' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_2\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_2'>Krankenhaus<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_2' id='input_11_2' type='text' value='' class='large'    placeholder='Krankenhaus *' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_13\" class=\"gfield gfield--type-number gfield--input-type-number gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_13'>Anzahl der Standorte<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_13' id='input_11_13' type='number' step='any'   value='' class='large'    placeholder='Anzahl der Standorte *' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_11_17\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_17'>Country<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_17' id='input_11_17' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Afghanistan' >Afghanistan<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Algeria<\/option><option value='American Samoa' >American Samoa<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua and Barbuda' >Antigua and Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Belarus<\/option><option value='Belgium' >Belgium<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet Island' >Bouvet Island<\/option><option value='Brazil' >Brazil<\/option><option value='British Indian Ocean Territory' >British Indian Ocean Territory<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cabo Verde' >Cabo Verde<\/option><option value='Cambodia' >Cambodia<\/option><option value='Cameroon' >Cameroon<\/option><option value='Canada' >Canada<\/option><option value='Cayman Islands' >Cayman Islands<\/option><option value='Central African Republic' >Central African Republic<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Christmas Island<\/option><option value='Cocos Islands' >Cocos Islands<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo' >Congo<\/option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the<\/option><option value='Cook Islands' >Cook Islands<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Czechia' >Czechia<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/option><option value='Denmark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Dominican Republic<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egypt<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Equatorial Guinea<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopia' >Ethiopia<\/option><option value='Falkland Islands' >Falkland Islands<\/option><option value='Faroe Islands' >Faroe Islands<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finland<\/option><option value='France' >France<\/option><option value='French Guiana' >French Guiana<\/option><option value='French Polynesia' >French Polynesia<\/option><option value='French Southern Territories' >French Southern Territories<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Germany<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Greece<\/option><option value='Greenland' >Greenland<\/option><option value='Grenada' >Grenada<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Haiti<\/option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands<\/option><option value='Holy See' >Holy See<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungary<\/option><option value='Iceland' >Iceland<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Iran<\/option><option value='Iraq' >Iraq<\/option><option value='Ireland' >Ireland<\/option><option value='Isle of Man' >Isle of Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italy<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Japan<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Korea, Democratic People&#039;s Republic of' >Korea, Democratic People&#039;s Republic of<\/option><option value='Korea, Republic of' >Korea, Republic of<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic<\/option><option value='Latvia' >Latvia<\/option><option value='Lebanon' >Lebanon<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaysia<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Marshall Islands<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Morocco<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Netherlands<\/option><option value='New Caledonia' >New Caledonia<\/option><option value='New Zealand' >New Zealand<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Norfolk Island<\/option><option value='North Macedonia' >North Macedonia<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Norway' >Norway<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestine, State of<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Romania<\/option><option value='Russian Federation' >Russian Federation<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon<\/option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Sao Tome and Principe<\/option><option value='Saudi Arabia' >Saudi Arabia<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovakia' >Slovakia<\/option><option value='Slovenia' >Slovenia<\/option><option value='Solomon Islands' >Solomon Islands<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >South Africa<\/option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands<\/option><option value='South Sudan' >South Sudan<\/option><option value='Spain' >Spain<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen<\/option><option value='Sweden' >Sweden<\/option><option value='Switzerland' >Switzerland<\/option><option value='Syria Arab Republic' >Syria Arab Republic<\/option><option value='Taiwan' >Taiwan<\/option><option value='Tajikistan' >Tajikistan<\/option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of<\/option><option value='Thailand' >Thailand<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad and Tobago<\/option><option value='Tunisia' >Tunisia<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks and Caicos Islands' >Turks and Caicos Islands<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='T\u00fcrkiye' >T\u00fcrkiye<\/option><option value='US Minor Outlying Islands' >US Minor Outlying Islands<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='United Arab Emirates' >United Arab Emirates<\/option><option value='United Kingdom' >United Kingdom<\/option><option value='United States' selected='selected'>United States<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Viet Nam' >Viet Nam<\/option><option value='Virgin Islands, British' >Virgin Islands, British<\/option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.<\/option><option value='Wallis and Futuna' >Wallis and Futuna<\/option><option value='Western Sahara' >Western Sahara<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c5land Islands' >\u00c5land Islands<\/option><option value='Other' >Other<\/option><\/select><\/div><\/div><div id=\"field_11_6\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_6'>Telefon<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_6' id='input_11_6' type='tel' value='' class='large'  placeholder='Telefon *' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_14\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_14'>Fragen oder Kommentare<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_14' id='input_11_14' class='textarea large'    placeholder='Fragen oder Kommentare'  aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_11_7\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_7' id='input_11_7' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='216.73.216.213' \/><\/div><\/div><div id=\"field_11_8\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_8' id='input_11_8' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_11_10\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_10' id='input_11_10' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_11_15\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_15' id='input_11_15' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><\/div><\/div>\n        <div 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Learn what&#8217;s changed and how they&#8217;ll impact you by reading our guide to the&nbsp;new vancomycin dosing changes&nbsp;here. The draft of the revised vancomycin therapeutic guidelines by Rybak et al. for the Infectious Diseases Society of America (and the ASHP, PIDS, and SIDP) are now available for public [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":7650,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[26],"tags":[28,27,37],"article-type":[49],"class_list":["post-4053","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-vancomycin","tag-auc","tag-trough","tag-vancomycin-dosing"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Vancomycin Dosing | New 2019 Therapuetic Guideline | What&#039;s Changed?<\/title>\n<meta name=\"description\" content=\"The draft 2019 vancomycin dosing guideline present AUC24\/MIC to be the most appropriate target for vancomycin dosing and monitoring. We examine the research\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/doseme-rx.com\/de\/vancomycin\/articles\/upcoming-dosing-guidelines\" \/>\n<meta property=\"og:locale\" content=\"de_DE\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Vancomycin Dosing | New 2019 Therapuetic Guideline | What&#039;s Changed?\" \/>\n<meta property=\"og:description\" content=\"The draft 2019 vancomycin dosing guideline present AUC24\/MIC to be the most appropriate target for vancomycin dosing and monitoring. 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