{"id":4514,"date":"2019-11-19T01:57:57","date_gmt":"2019-11-18T15:57:57","guid":{"rendered":"https:\/\/doseme-rx.com\/?p=4514"},"modified":"2021-04-13T16:41:47","modified_gmt":"2021-04-13T06:41:47","slug":"trough-level-recommendations","status":"publish","type":"post","link":"https:\/\/doseme-rx.com\/es\/vancomycin\/articles\/trough-level-recommendations","title":{"rendered":"Vancomycin trough levels: Upcoming 2019 therapeutic drug monitoring recommendations"},"content":{"rendered":"\n<p><strong>Note: The new&nbsp;vancomycin dosing guidelines&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>The 2009 guidelines for monitoring&nbsp;<a href=\"https:\/\/doseme-rx.com\/vancomycin-dosing\">vancomycin<\/a> levels&nbsp;in&nbsp;adult patients&nbsp;recommended patients:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Maintain trough serum&nbsp;vancomycin concentrations&nbsp;of at least 10 mg\/L for all infections to avoid the potential for resistance <\/li><li>Maintain trough serum&nbsp;vancomycin concentrations&nbsp;of 15-20mg\/L      for&nbsp;complicated infections <\/li><\/ul>\n\n\n\n<p>The <a href=\"https:\/\/doseme-rx.com\/news\/20200330-vancomycin-dosing-guidelines-what-to-know\">2020 vancomycin therapeutic guidelines<\/a> recommends a move away from monitoring&nbsp;vancomycin&nbsp;trough&nbsp;levels&nbsp;to targeting an AUC<sub>24<\/sub>:MIC (24-hour area under the curve (AUC) to minimum&nbsp;inhibitory concentration&nbsp;ratio). Dosing vancomycin using trough-only monitoring is no longer recommended.<\/p>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\">Vancomycin Dosing: What&#8217;s Changing?<\/h2>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p>The <a href=\"https:\/\/doseme-rx.com\/news\/20190601-vancomycin-dosing-therapeutic-guideline-2019\">updated guidelines<\/a> recommend the following: &nbsp;&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Drawing two levels, including one&nbsp;trough concentration&nbsp;and one      peak&nbsp;steady-state&nbsp;concentration, obtained 1-2 hours post-infusion <\/li><li>Utilizing a Bayesian software program to monitor the AUC<\/li><li>Maintaining a Bayesian-derived&nbsp;AUC\/MIC<sub>BMD<\/sub> (broth microdilution) of 400 to 600 for&nbsp;serious infections<\/li><\/ul>\n\n\n\n<p>In our video, <a href=\"https:\/\/doseme-rx.com\/news\/author\/kkuperdosemehealth-com\">Dr Kristi Kuper<\/a> PharmD, BCPS discusses and breaks down the evidence for the key changes in the updated vancomycin dosing guidelines:<\/p>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<div class=\"video-responsive\">\n<iframe width=\"420\" height=\"315\" src=\"https:\/\/www.youtube.com\/embed\/e6rWOSw3ols?rel=0\" frameborder=\"0\" allow=\"accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen=\"\"><\/iframe>\n<\/div>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\">What is vancomycin?<\/h2>\n\n\n\n<p>Vancomycin is an antibiotic used to treat serious, life-threatening infections, including those caused by&nbsp;methicillin-resistant <em>Staphylococcus aureus.<\/em><\/p>\n\n\n\n<p>Vancomycin is given intravenously (by injection into a vein) to treat infections such as blood poisoning (septicemia), heart valve infections (endocarditis), bone infections (osteomyelitis), blood infections (bacteremia), certain types of pneumonia, and meningitis.<\/p>\n\n\n\n<p>It is often the drug of choice for methicillin-resistant <em>Staphylococcus epidermidis<\/em> (MRSE)<em> <\/em>and&nbsp;<em>methicillin-resistant Staphylococcus aureus<\/em>&nbsp;(MRSA) infections, especially when they are associated with implanted prosthetic devices such as heart valves, artificial hips, and indwelling catheters. <\/p>\n\n\n\n<p>Vancomycin can also be given before certain surgeries to prevent an infection.<\/p>\n\n\n\n<p>Although it\nwas originally approved by the FDA in 1958, it was not widely used until the\nlate 1970s when resistance to other antibiotics started to emerge<\/p>\n\n\n\n<p>Monitoring the level of vancomycin is important because its effectiveness relies on keeping blood levels above a minimum concentration for the entire duration of therapy (also referred to as total drug exposure). <\/p>\n\n\n\n<p>If the vancomycin dose is too low, an inadequate concentration of vancomycin will not treat the infection and it can lead to the development of resistant bacteria. Increasing resistance to vancomycin means that higher doses are necessary to make the drug effective against infections, and in some cases these higher doses cannot be given safely. If the dose is too high, excessive concentrations of <a href=\"https:\/\/doseme-rx.com\/news\/20200808-vancomycin-side-effects\">vancomycin can result in serious side effects<\/a>, including hearing loss (ototoxicity) and kidney damage (nephrotoxicity). &nbsp;<\/p>\n\n\n\n<p>The goal is to find a dose for vancomycin that is both safe and effective.<\/p>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Vancomycin&nbsp;Therapeutic\nDrug Monitoring<\/strong><\/h3>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p>Vancomycin blood levels are drawn at timed intervals to measure drug levels during treatment. Vancomycin has a narrow therapeutic index, which is the ratio between the toxic and effective dose of medication.<\/p>\n\n\n\n<p>As soon as vancomycin enters the body, the drug gets distributed throughout, and then the kidneys begin to work to remove it from the body.<\/p>\n\n\n\n<p>For vancomycin to be effective, a person must receive doses at regular intervals with the goal of getting to a point where the drug levels in the body remain stable or consistent, known as steady-state. <\/p>\n\n\n\n<p>To maintain this&nbsp;steady-state, it&#8217;s important to individualize the dose because each person\u2019s body will process and remove vancomycin at different rates based upon their age, underlying health status, weight, kidney function, and other medications they are taking. <\/p>\n\n\n\n<p>Other medications used at the same time as vancomycin can increase or decrease the concentration of the drug in the blood so close monitoring and evaluation of patients is advised.<\/p>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Vancomycin and Acute Kidney Injury<\/strong><\/h3>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p>A dangerous side effect of&nbsp;vancomycin therapy&nbsp;is kidney damage (acute kidney injury, or AKI). Acute kidney injury occurs quickly, usually within the first 10 days of therapy.<\/p>\n\n\n\n<p>Although it can be reversed, this is not always the case. Some patients may see an improvement in their kidney function but it doesn\u2019t recover fully. For other patients, they may never recover and will require hemodialysis.<\/p>\n\n\n\n<p>Even mild AKI can significantly reduce patient survival rates, increase concomitant illness, prolong hospitalizations, and escalating healthcare costs. Certain patients are at&nbsp;high risk&nbsp;of developing AKI, including those who are obese, have pre-existing kidney problems, and the critically ill.<\/p>\n\n\n\n<p>In patients receiving vancomycin, a greater&nbsp;risk of&nbsp;nephrotoxicity&nbsp;occurs when&nbsp;doses&nbsp;exceed 4 grams per day and&nbsp;trough levels&nbsp;are higher than 15mcg\/mL and an&nbsp;AUC&nbsp;above 600 mg-h\/L is present. <\/p>\n\n\n\n<p>Vancomycin associated AKI can be measured in different ways, but a common definition of AKI used is either<\/p>\n\n\n\n<ol class=\"wp-block-list\"><li>An increase in&nbsp;serum creatinine of&nbsp;&gt;0.5 mg\/dL or a 50% increase from baseline in consecutive daily readings, or <\/li><li>A decrease in calculated&nbsp;creatinine clearance&nbsp;of 50% from baseline on two consecutive days in the absence of an alternative explanation. Newer studies suggest that a more sensitive threshold of an increase in&nbsp;serum creatinine&nbsp;&gt;0.3 mg\/dL over a 48 hour period may be an indicator of AKI.<\/li><\/ol>\n\n\n\n<p>AKI can be potentiated in patients that are receiving other medications that also rely on the kidneys for processing.<\/p>\n\n\n\n<p>This is defined as a drug-drug interaction. &nbsp;Drug-drug interactions are common in seriously&nbsp;ill patients&nbsp;receiving vancomycin. <\/p>\n\n\n\n<p>It is important to monitor kidney (renal) function in patients receiving vancomycin who are also receiving other medications that can damage the kidneys such as antimicrobials (e.g. amphotericin B, aminoglycosides, polymyxins, or piperacillin\/tazobactam), loop diuretics, or certain types of chemotherapy such as cisplatin. <\/p>\n\n\n\n<p>In the past,&nbsp;vancomycin doses&nbsp;have been adjusted to target a specific&nbsp;trough level. &nbsp;It is now increasingly clear that the&nbsp;trough level&nbsp;does not accurately reflect total vancomycin exposure. New&nbsp;retrospective studies&nbsp;also show that&nbsp;AUC-guided&nbsp;vancomycin dosing&nbsp;may reduce the occurrence of vancomycin-associated AKI.<\/p>\n\n\n\n<p>In hospitalized patients who were using trough-only dosing, there was an 8% incidence of AKI compared to those using&nbsp;AUC&nbsp;dosing who had a 0%-2% incidence of AKI. Study results show that&nbsp;AUC&nbsp;is the driver of effectiveness and the risk of AKI is related to trough, and potentially&nbsp;AUC. As a result, the new guidelines focus on measuring&nbsp;AUC&nbsp;<sub>24<\/sub>.<\/p>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\">Vancomycin Dosing: 2009 vs 2020<\/h2>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p>Vancomycin dosing depends on a variety of factors, including kidney function (renal function), other nephrotoxic drugs the person may be receiving, age, and weight.<\/p>\n\n\n\n<p>Historically, the primary reference designed to guide&nbsp;vancomycin use&nbsp;is the \u00ab2009&nbsp;Therapeutic Monitoring of Vancomycin&nbsp;in&nbsp;Adult Patients: A&nbsp;Consensus Review&nbsp;of the&nbsp;American Society of Health-System Pharmacists, the&nbsp;Infectious Diseases&nbsp;Society of America&nbsp;(IDSA), and the&nbsp;Society of&nbsp;Infectious Diseases&nbsp;Pharmacists.&nbsp;<\/p>\n\n\n\n<p>&nbsp;The 2009 guidelines recommend doses of 15\u201320 mg\/kg (based on actual&nbsp;body weight) given every 8\u201312 hours for most patients with&nbsp;normal&nbsp;renal function&nbsp;to achieve the suggested&nbsp;serum concentrations&nbsp;for infections where the bacteria are relatively sensitive.<\/p>\n\n\n\n<p>In seriously&nbsp;ill patients, a&nbsp;loading dose&nbsp;of 25\u201330 mg\/kg (based on actual&nbsp;body weight) can be used to quickly meet the&nbsp;target trough&nbsp;serum&nbsp;vancomycin concentration. These recommendations have been changed for 2019.<\/p>\n\n\n\n<p>In the 2009&nbsp;vancomycin dosing&nbsp;guidelines, it was recommended that&nbsp;vancomycin troughs&nbsp;remain above 10&nbsp;mcg\/mL to prevent antibiotic resistance from developing and that concentrations of 15 to 20&nbsp;mcg\/mL should be targeted for certain patients with&nbsp;complicated infections.<\/p>\n\n\n\n<p>It was expected that the higher trough goal would reach the goal of an AUC<sub>24<\/sub>:MIC \u2265400 mg\u2219h\/L in most patients with&nbsp;complicated infections&nbsp;when the organism\u2019s minimum&nbsp;inhibitory concentration&nbsp;was \u22641&nbsp;mcg\/mL. The trough should be collected before the 4th dose is administered (prior to&nbsp;steady state).<\/p>\n\n\n\n<p>Unfortunately, the practice of waiting until the&nbsp;fourth dose&nbsp;to measure the&nbsp;trough level&nbsp;may expose a patient to several days of sub-optimal therapy. <\/p>\n\n\n\n<p>In 2019, a new set of draft guidelines were posted for public review. In March the&nbsp;<a href=\"https:\/\/doseme-rx.com\/news\/20200330-vancomycin-dosing-guidelines-what-to-know\">2020 vancomycin monitoring guidelines&nbsp;<\/a>were released during the COVID-19 pandemic response.<\/p>\n\n\n\n<p>According to these guidelines, a&nbsp;loading dose&nbsp;of 25-35 mg\/kg can be administered to quickly reach targeted concentrations in critically&nbsp;ill patients&nbsp;with serious&nbsp;MRSA&nbsp;infections&nbsp;and&nbsp;normal&nbsp;renal function.<\/p>\n\n\n\n<p>Although loading doses&nbsp;should be based on actual&nbsp;body weight, the maximum dose should not exceed 3000 mg. &nbsp;More frequent therapeutic monitoring should also be performed in obese patients, patients with frequently changing kidney function, or in patients who are receiving vancomycin for 3 days or more. <\/p>\n\n\n\n<p>New research\nsuggests for many patients, an effective AUC<sub>24<\/sub>:MIC target of 400-600\nmg.h\/L can be achieved with significantly lower&nbsp;trough\nconcentrations&nbsp;than previously recommended in 2009.<\/p>\n\n\n\n<p>The 2020 vancomycin dosing guidelines now recommend a different&nbsp;dosing regimen. <\/p>\n\n\n\n<p>A <a href=\"https:\/\/doseme-rx.com\/benefits\">Bayesian approach<\/a> allows&nbsp;vancomycin levels&nbsp;to be drawn within the first 24 to 48 hours instead of waiting for&nbsp;steady-state&nbsp;conditions (after the 3rd or 4th dose).<\/p>\n\n\n\n<p>This information can be used to change subsequent dosing. As part of their output, Bayesian software programs may recommend new treatment regimens such as front-loading doses&nbsp;with a transition to a lower maintenance&nbsp;dosing regimen&nbsp;to achieve target drug concentrations within the first 24 to 48 hours among critically-ill patients.<\/p>\n\n\n\n<p>A benefit of using Bayesian&nbsp;AUC&nbsp;estimates is it can be applied to all patients (including obese, critically-ill patients, pediatrics, and patients with kidney dysfunction).<\/p>\n\n\n\n<p>Currently, it is preferred to estimate the Bayesian&nbsp;AUC&nbsp;on two&nbsp;vancomycin concentrations&nbsp;(peak and trough). &nbsp;The goal is to target a Bayesian-derived&nbsp;AUC\/MIC<sub>-BMD <\/sub>ratio of 400 to 600 to maximize drug efficacy while minimizing the risk of AKI.<\/p>\n\n\n\n<p>The most accurate way to dose vancomycin is through&nbsp;<a href=\"https:\/\/doseme-rx.com\/news\/20191213-auc24-vancomycin-dosing\">AUC-guided dosing and monitoring<\/a>. The preferred approach to monitor&nbsp;AUC&nbsp;involves the use of Bayesian software programs, and drawing two&nbsp;vancomycin levels&nbsp;(i.e. shortly after the end of infusion and at the end of the&nbsp;dosing interval) to estimate the&nbsp;AUC.<\/p>\n\n\n\n<p>The frequency of drawing levels following therapy can vary from once weekly for stable patients to once daily for most other patients (such as those with kidney dysfunction, or those who are critically-ill).<\/p>\n\n\n\n<p>If you use a <a href=\"https:\/\/doseme-rx.com\/\">Bayesian dosing software <\/a>with richly sampled PK data you may be able to accomplish this with minimal PK sampling (i.e. a single trough level) that provides AUC-guided vancomycin dosing recommendations in real-time. <\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Try DoseMeRx <\/h3>\n\n\n\n<p>Learn more about our extensive range of vancomycin models plus other drug models and trial DoseMeRx free for 14-days \u2013&nbsp;<a href=\"https:\/\/doseme-rx.com\/start-trial\">start your free trial now \u2192<\/a><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Related Posts<\/h3>\n\n\n\n<p>Here are some more vancomycin resources for you:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><a href=\"https:\/\/doseme-rx.com\/news\/20200330-vancomycin-dosing-guidelines-what-to-know\">Official Vancomycin Dosing Guidelines<\/a><\/li><li><a href=\"https:\/\/doseme-rx.com\/vancomycin-dosing-calculator\">Vancomycin AUC Calculator<\/a><\/li><li><a href=\"https:\/\/doseme-rx.com\/vancomycin-auc-conversion-toolkit\">Vancomycin AUC Conversion Toolkit<\/a><\/li><\/ul>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p><em>Authors note: This article was last updated in May 2020. <\/em><\/p>\n\n\n\n<hr class=\"wp-block-separator\"\/>\n\n\n\n<p><strong>Sources<\/strong><\/p>\n\n\n\n<p><em>Rybak MJ, Le J, Lodise TP, Levine DP, Bradley JS, Liu C, Mueller BA, Pai MP, Wong-Beringer A,&nbsp;Rotschafer JC, Rodvold KA, Maples HD,&nbsp;Lomaestro B; et al. \u201c<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/32227354\" target=\"_blank\" rel=\"noreferrer noopener\">Therapeutic Monitoring of Vancomycin: A Revised Consensus Guideline<\/a>.\u201d. Accessed November 6, 2019.<\/em><\/p>\n\n\n\n<p><em>American Journal of Health System Pharmacists. \u201cTherapeutic Monitoring of Vancomycin&nbsp;in&nbsp;Adult Patients: \u201c<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/19106348\" target=\"_blank\" rel=\"noreferrer noopener\">A&nbsp;Consensus Review&nbsp;of the&nbsp;American Society of Health-System Pharmacists, the&nbsp;Infectious Diseases&nbsp;Society of America, and the&nbsp;Society of&nbsp;Infectious Diseases&nbsp;Pharmacists<\/a>.\u201d Published 2009. Accessed November 6, 2019.<\/em><\/p>\n\n\n\n<p><em>Levine DP. Vancomycin: a history.&nbsp;Clin Infect Dis. 2006;42 Suppl 1:S5-12. <a href=\"https:\/\/academic.oup.com\/cid\/article\/42\/Supplement_1\/S5\/275962\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/academic.oup.com\/cid\/article\/42\/Supplement_1\/S5\/275962<\/a>. Accessed November 6, 2019.<\/em><\/p>\n\n\n\n<p><em>MedlinePlus Drug Information. Vancomycin Injection. Available online at <a href=\"https:\/\/medlineplus.gov\/druginfo\/meds\/a601167.html\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/medlineplus.gov\/druginfo\/meds\/a601167.html<\/a>. Accessed November 6, 2019.<\/em><\/p>\n\n\n\n<p><em>ANI Pharmaceuticals. Vancocin (vancomycin) [package insert]. U.S. Food and Drug Administration website. <a href=\"https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2017\/060180s047lbl.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2017\/060180s047lbl.pdf<\/a>. Revised January 2017. Accessed November 6, 2019.<\/em><\/p>\n\n\n\n<p><em>Hale CM, Seabury RW, Steele JM, Darko W, Miller CD. Are&nbsp;vancomycin&nbsp;trough&nbsp;concentrations&nbsp;of 15 to 20 mg\/L associated with increased attainment of an&nbsp;AUC\/MIC \u2265 400 in patients with presumed&nbsp;MRSA&nbsp;infection? J Pharm Pract.2017;30(3):329-335. doi: 10.1177\/0897190016642692. <a href=\"https:\/\/journals.sagepub.com\/doi\/abs\/10.1177\/0897190016642692\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/journals.sagepub.com\/doi\/abs\/10.1177\/0897190016642692<\/a>. Accessed November 6, 2019.<\/em><\/p>\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\">Solicita una demo<\/h2>\r\n\t<p>Mira c\u00f3mo DoseMeRx trabaja y se integra en tu rutina de trabajo diaria.<\/p>\n<p>Solicita una demo a continuaci\u00f3n. Puedes telefonearnos al <a href=\"tel:+18323583308\">+1 (832) 358-3308<\/a>\u00a0o email\u00a0<a href=\"mailto:hello@dosemehealth.com\">hello@dosemehealth.com<\/a>.<\/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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class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; se\u00f1ala los campos obligatorios<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_11' id='gform_11'  action='\/es\/wp-json\/wp\/v2\/posts\/4514#gf_11' data-formid='11' novalidate><div class='gf_invisible ginput_recaptchav3' data-sitekey='6LcKHvQqAAAAANhsXAUIozVdQgdVqbUaVSmOOEQ8' data-tabindex='0'><input id=\"input_e96277ef775691b32a665d00a36bba25\" class=\"gfield_recaptcha_response\" type=\"hidden\" name=\"input_e96277ef775691b32a665d00a36bba25\" value=\"\"\/><\/div>\n                        <div class='gform-body gform_body'><div id='gform_fields_11' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_11_5\" class=\"gfield gfield--type-email gfield--input-type-email 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_5'>Email<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='Email *' 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'>Nombre<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='Nombre *' 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'>Apellido<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='Apellido *' 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'>Hospital<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='Hospital *' 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'>N\u00famero de sitios<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='N\u00famero de sitios *' 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'>Tel\u00e9fono<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='Tel\u00e9fono *' 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'>Preguntas o comentarios<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_14' id='input_11_14' class='textarea large'    placeholder='Preguntas o comentarios'  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='216.73.216.147' \/><\/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    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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 2009 guidelines for monitoring&nbsp;vancomycin levels&nbsp;in&nbsp;adult patients&nbsp;recommended patients: Maintain trough serum&nbsp;vancomycin concentrations&nbsp;of at least 10 mg\/L for all infections to avoid the potential for resistance Maintain trough serum&nbsp;vancomycin concentrations&nbsp;of 15-20mg\/L [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":7630,"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-4514","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 trough levels: Upcoming 2019 Guideline Changes<\/title>\n<meta name=\"description\" content=\"Stay up to date with current official dosing recommendations for Vancomycin. We explain recent changes so that you can give the best care possible.\" \/>\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\/es\/vancomycin\/articles\/trough-level-recommendations\" \/>\n<meta property=\"og:locale\" content=\"es_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Vancomycin trough levels: Upcoming 2019 Guideline Changes\" \/>\n<meta property=\"og:description\" content=\"Stay up to date with current official dosing recommendations for Vancomycin. 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