{"id":8137,"date":"2020-11-25T13:33:23","date_gmt":"2020-11-25T03:33:23","guid":{"rendered":"https:\/\/doseme-rx.com\/?p=6037"},"modified":"2022-07-27T05:19:56","modified_gmt":"2022-07-26T19:19:56","slug":"optimizing-vancomycin-auc-dosing-case-study","status":"publish","type":"post","link":"https:\/\/doseme-rx.com\/fr\/vancomycin\/case-studies\/optimizing-vancomycin-auc-dosing-case-study","title":{"rendered":"Optimizing Vancomycin AUC Dosing in Vascular Surgery Patients at University Hospitals of Leicester NHS Trust"},"content":{"rendered":"\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h3 class=\"wp-block-heading\">Key Findings<\/h3>\n\n\n\n<ul class=\"wp-block-list\"><li>DoseMeRx improved the overall accuracy and precision of vancomycin dosing in patients with vascular infections.<\/li><li>Significantly fewer patients missed vancomycin doses in the DoseMeRx group, which can have direct implications on improving medication safety.<\/li><li>The use of DoseMeRx resulted in a significantly higher proportion of patients who reached the therapeutic AUC24 target, leading to improved pharmacodynamic outcomes in patients treated with vancomycin.<\/li><\/ul>\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\" id=\"exec-summary\">Executive Summary<\/h2>\n\n\n\n<p>Vancomycin is a widely used antibiotic for gram-positive infections. While therapeutic drug monitoring of vancomycin blood levels is a longstanding practice, a shift has occurred over the past several years from trough-based monitoring to area-under-the-curve-based monitoring. This poses new challenges to clinicians, as the measurement and calculation of area under the curve (AUC) is less straightforward than evaluating trough levels.<\/p>\n\n\n\n<p>One solution to those challenges is individualized dosing via Bayesian decision support software, which is the preferred approach recommended by the <a href=\"https:\/\/doseme-rx.com\/news\/20200610-webinar-implementing-vancomycin-guidelines-what-you-need-to-know\">2020 vancomycin dosing guidelines<\/a>.<\/p>\n\n\n\n<p>The study performed at Glenfield Hospital, <a href=\"https:\/\/www.leicestershospitals.nhs.uk\/\">University Hospitals of Leicester NHS Trust<\/a>, and published in the British Journal of Clinical Pharmacology, compared vancomycin AUC outcomes in vascular surgery patients managed with DoseMeRx, a Bayesian decision support tool, to patients managed by traditional trough-based dosing methods.(1)<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"problem\">The Problem<\/h2>\n\n\n\n<p>Vancomycin is a glycopeptide antibiotic used for gram-positive bacterial infections. Due to the narrow therapeutic index and potential toxicities of vancomycin, use of this drug involves therapeutic drug monitoring (TDM) of vancomycin blood levels.<\/p>\n\n\n\n<p>While AUC has long been accepted as the pharmacodynamic endpoint for vancomycin, and until recently, measurement of a vancomycin trough was accepted as a surrogate marker for AUC exposure. However, given increasing data indicating that trough is not a predictable surrogate for AUC, t<strong>he 2020 vancomycin dosing guidelines (endorsed by IDSA, SIDP, ASHP, and PIDS)a recommend monitoring AUC over trough.<\/strong>(2)<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"issues\">Issues in Conventional Dosing of Vancomycin<\/h2>\n\n\n\n<p>The shift from trough-based to AUC-based vancomycin dosing grew from the increasing body of evidence that vancomycin troughs prove to be an unreliable marker of AUC exposure, often resulting in patients receiving higher-than-necessary doses and, subsequently, increased toxicity. Counterintuitively, pharmacokinetic studies suggest that some patients may also have sub-therapeutic AUC values at therapeutic or supra-therapeutic trough values, further highlighting the discontinuity between AUC exposure and trough values. Additionally, <strong>clinical studies demonstrate improved patient outcomes when AUC is maintained in target range in infections with methicillin- resistant Staphylococcus aureus and Enterococcus species.(3,4,5<\/strong>)<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"challenges\">Current Challenges Associated with Vancomycin Dosing<\/h2>\n\n\n\n<p>There are many challenges to implementing AUC- guided <a href=\"https:\/\/doseme-rx.com\/vancomycin-dosing\">vancomycin dosing<\/a>. Unlike trough values, AUC exposure cannot be measured directly from a laboratory value viewed in the medical record \u2013 it must be calculated either with pharmacokinetic equations or with software support. Additionally, as vancomycin dosing has been a paradigm of clinical pharmacy for decades, the cognitive shift from trough-based vancomycin dosing to AUC-guided dosing can prove a difficult transition. Finally, without software assistance such as DoseMeRx, AUC measurement involves waiting until the patient is at steady state, then drawing two blood levels at fixed times. These levels are relative to the timing of the dose, which can often result in missed or delayed doses and the need for repeat blood draws.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"relevance\">Clinical Relevance<\/h2>\n\n\n\n<p>The guideline supports two methodologies for AUC monitoring: traditional PK modeling with multiple blood\/serum levels and Bayesian kinetic modeling with single or multiple blood\/serum levels.(2) <strong>The present study assesses AUC outcomes in patients using the Bayesian method as highlighted in the 2020 guidelines utilizing DoseMeRx.<\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">The Role of Missed Doses on Medication Safety<\/h3>\n\n\n\n<p>A medication that is ordered but not dispensed or administered to the patient is classified as a medication error. Reducing medication errors is a global goal in healthcare that is recognized by Regulatory, Quality and Accreditation organizations.(6, 7)<\/p>\n\n\n\n<p>A missed dose of a medication can have detrimental impacts on a patient\u2019s care both in and outside of the hospital. For example, in patients who are being treated for an infectious disease, such as a vascular surgery infection, a missed dose of the treating antibiotic can result in a worsening of the infection or could increase the potential for antimicrobial resistance to occur due to suboptimal concentrations, both in the blood, but also at the site of infection. This case study highlights the impact that utilizing DoseMeRx had on reducing the number of missed doses, thus having a direct impact on improving the safe use of medications.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"outline\">Outline of the Study<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">Aim<\/h3>\n\n\n\n<p>The aim of this observational cohort study was to assess the outcomes related to the implementation of bed-side, Bayesian-guided vancomycin dosing using DoseMeRx.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Design<\/h3>\n\n\n\n<p>The study cohort consisted of vascular surgery patients admitted to Glenfield Hospital, <a href=\"https:\/\/www.leicestershospitals.nhs.uk\/\">University Hospitals of Leicester NHS Trust. <\/a>Prior to initiation of the study, physicians and pharmacists were given access to DoseMeRx and trained on use of a clinically-validated, one-compartment vancomycin dosing model. Vancomycin dosing was primarily managed<br>by clinical pharmacy staff, but physicians managed vancomycin dosing independently on the weekends. Vancomycin levels were typically drawn pre-steady-state, between the loading dose and the first maintenance dose.<\/p>\n\n\n\n<p>The DoseMeRx group prospectively enrolled patients between June 26, 2018 and February 28, 2019 who were prescribed intravenous vancomycin and were not on hemodialysis. The most common indication for antibiotics in the both groups was diabetic foot infection, and the most commonly co-administered antibiotics were meropenem and piperacillin\/ tazobactam. The prospective group was compared against a similar retrospective control group for whom vancomycin was not dosed via DoseMeRx.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Primary outcome<\/h3>\n\n\n\n<p>The primary outcome of the study was 24-hour AUC (AUC24) value for each group. For the prospective group, AUC24 values were determined using DoseMeRx. For the control group, laboratory values and vancomycin dosing regimens were retrospectively entered into DoseMeRx to assess AUC24 exposure. From the AUC24 data, mean AUC24 exposure and percentage time in therapeutic range (%TTR) were calculated.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Secondary outcomes<\/h3>\n\n\n\n<p>Secondary outcomes included: <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>acute kidney injury (AKI),<\/li><li>all-cause 30-day mortality,<\/li><li>amputation rates,<\/li><li>re-admission rates<\/li><li>number of missed doses.<\/li><\/ul>\n\n\n\n<blockquote class=\"wp-block-quote is-style-default is-layout-flow wp-block-quote-is-layout-flow\"><p><em>It is important to note that the target AUC range in this study (350-450 mg\/L*h) was slightly lower than the range espoused by the 2020 vancomycin dosing guidelines (400-600 mg\/L*h).<\/em><\/p><\/blockquote>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"results\">Results<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>Vancomycin levels predicted by DoseMeRx had a high correlation with measured vancomycin levels (r2= 0.86).<\/li><li>The average number of missed doses was five times lower in the DoseMeRx group than in the control group (0.23 doses per course vs 1.04 doses per course, respectively; p&lt;0.00001).<\/li><li>A significantly higher percentage of patients in the DoseMeRx group achieved an average 24 hour AUC within the goal range used in the study when compared to the control group (68.3% vs 41.7%, p = 0.005).<\/li><\/ul>\n\n\n\n<p>In the study, 104 patients were enrolled in the DoseMeRx group and 139 patients were included in the retrospective control group. The two study arms were well matched (Table 1), with the exception that meropenem was more commonly used as a concomitant antibiotic in the control group and piperacillin\/tazobactam was more commonly used in the DoseMeRx group.<\/p>\n\n\n\n<p>The study achieved its primary outcome. Researchers found a statistically significant higher proportion of patients in the DoseMeRx group achieved mean AUC24 values within goal range as compared to the control group. In addition, the number of doses that were outside of therapeutic AUC24 range were significantly higher in the control group (p&lt;0.005).<\/p>\n\n\n\n<p>There were no differences in the clinically related secondary outcomes measured, but a reduction in missed doses was seen (Figure 1).<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/doseme-rx.com\/wp-content\/uploads\/2020\/11\/J6290_DOS_NHS-Case-Study_Table1_BaselineDemographics-1024x657.jpg\" alt=\"Vancomycin AUC Target Attainment in Vascular Surgery Patients Study Demographics\" class=\"wp-image-6350\"\/><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">Improving Medication Safety By Reducing Missed Doses<\/h3>\n\n\n\n<p>Bayesian guided dosing resulted in fewer missed doses of vancomycin (Figure 1). DoseMeRx can interpret pre-steady state vancomycin levels and those levels drawn outside of the normally scheduled time.<\/p>\n\n\n\n<p>This flexibility is beneficial because it eliminates delays or omissions of doses that may occur when having to wait for a vancomycin level to be drawn at a specific time of day or point in the patient\u2019s course.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" width=\"1024\" height=\"529\" src=\"https:\/\/doseme-rx.com\/wp-content\/uploads\/2020\/11\/J6290_DOS_NHS-Case-Study_Update2_WEB-1024x529.jpg\" alt=\"Percentage of Missed Doses - DoseMeRx vs Control\" class=\"wp-image-6297\" srcset=\"https:\/\/doseme-rx.com\/wp-content\/uploads\/2020\/11\/J6290_DOS_NHS-Case-Study_Update2_WEB-1024x529.jpg 1024w, https:\/\/doseme-rx.com\/wp-content\/uploads\/2020\/11\/J6290_DOS_NHS-Case-Study_Update2_WEB-300x155.jpg 300w, https:\/\/doseme-rx.com\/wp-content\/uploads\/2020\/11\/J6290_DOS_NHS-Case-Study_Update2_WEB-768x397.jpg 768w, https:\/\/doseme-rx.com\/wp-content\/uploads\/2020\/11\/J6290_DOS_NHS-Case-Study_Update2_WEB.jpg 1161w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><figcaption>Figure 1: Percentage of Missed Doses<\/figcaption><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">Predictive Performance of DoseMeRx<\/h3>\n\n\n\n<p>The study compared the difference between the levels that were predicted by DoseMeRx vancomycin model with the actual measured levels. Across all patients, there was a strong correlation between what was estimated by DoseMeRx and the vancomycin levels reported by the Lab.<\/p>\n\n\n\n<blockquote class=\"wp-block-quote is-style-default is-layout-flow wp-block-quote-is-layout-flow\"><p><em>The predictive performance of DoseMeRx, as assessed by comparing observed concentrations and model predicted values, showed good correlation (r2= 0.86).<\/em><\/p><\/blockquote>\n\n\n\n<blockquote class=\"wp-block-quote is-style-default is-layout-flow wp-block-quote-is-layout-flow\"><p><em>The average of absolute difference between measured and predicted concentration was 1.57mg\/L for patients in the control group vs. 1.48 mg\/L for DoseMeRx.<\/em><\/p><\/blockquote>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"bayesian\">DoseMeRx Bayesian Dose Forecasting<\/h2>\n\n\n\n<p>Bayesian dosing combines pharmacokinetic modeling with statistical probabilities to provide individualized dosing for patients. Bayesian models take into account readily available patient information &#8211; such as height, weight, renal function, and drug levels \u2013 and estimate a patient\u2019s ability to absorb, process, and clear a drug from their system. When a patient is initiated on a drug, the pharmacokinetic model will be largely derived from population data; however, as more data is entered, a truly individualized dosing model develops.<\/p>\n\n\n\n<p>While Bayesian dose forecasting is a long-established clinical tool, its use was previously restricted to clinicians who were also experienced with statistics and information technology. DoseMeRx provides the clinical benefits of Bayesian dose forecasting plus a user-friendly interface that is accessible to the average clinician. All of this, along with the training and support offered by DoseMeRx, make bringing the benefits of Bayesian dosing to the bedside easier than ever before.<\/p>\n\n\n\n<p>While Bayesian dose forecasting is a long-established clinical tool, its use was previously restricted to clinicians who were also experienced with statistics and information technology. DoseMeRx provides the clinical benefits of Bayesian dose forecasting plus a user-friendly interface that is accessible to the average clinician. All of this, along with the training and support offered by DoseMeRx, make bringing the benefits of Bayesian dosing to the bedside easier than ever before.<\/p>\n\n\n\n<blockquote class=\"wp-block-quote is-style-default is-layout-flow wp-block-quote-is-layout-flow\"><p><em>DoseMeRx makes bringing the benefits of Bayesian dosing to the bedside easier than ever before.<\/em><\/p><\/blockquote>\n\n\n\n<h3 class=\"wp-block-heading\">References<\/h3>\n\n\n\n<p>1 Vali L et al. Br J Clin Pharmacol; 2020: 1\u2013 10.<br>2 Rybak M et al. Am J Health-Syst Pharm; 2020: 7(11):835-864.<br>3 Brown J et al. AAC;2012, 56 (2): 634-638.<br>4 Jumah MT et al. AAC: 2018:62(3).<br>5 Mogle B et al. Int J Antimicrob Agents; 2018: 52(6):805-810.<br>6 <a href=\"https:\/\/www.nccmerp.org\/about-medication-errors\">https:\/\/www.nccmerp.org\/about-medication-errors<\/a> <br>7 The Joint Commission (<a href=\"https:\/\/www.jointcommission.org\/\">https:\/\/www.jointcommission.org\/<\/a>), National Health Services (<a href=\"https:\/\/www.england.nhs.uk\/patient-safety\/national-medicines-safety-programme\/\">https:\/\/www.england.nhs.uk\/patient-safety\/national-medicines-safety-programme\/<\/a>), FDA (<a href=\"https:\/\/www.fda.gov\/drugs\/drug-information-consumers\/working-reduce-medication-errors\">https:\/\/www.fda.gov\/drugs\/drug-information-consumers\/working-reduce-medication-errors<\/a>), Leapfrog (<a href=\"https:\/\/www.leapfroggroup.org\/ratings-reports\">https:\/\/www.leapfroggroup.org\/ratings-reports<\/a>)<\/p>\n\n\n\n<div class=\"wp-block-columns alignfull no-margin no-gap is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<div class=\"wp-block-group has-darkpurple-background-color has-background\"><div class=\"wp-block-group__inner-container is-layout-flow wp-block-group-is-layout-flow\"><div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large\"><img decoding=\"async\" src=\"https:\/\/doseme-rx.com\/wp-content\/uploads\/2020\/11\/J6290_DOS_NHS_CaseStudy_report_mockup-1024x683.png\" alt=\"NHS Vancomycin Case Study\" class=\"wp-image-6363\"\/><\/figure>\n<\/div><\/div><\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<div class=\"wp-block-group has-darkblue-background-color has-background\"><div class=\"wp-block-group__inner-container is-layout-flow wp-block-group-is-layout-flow\">\n<h2 class=\"has-text-align-left has-white-color has-text-color wp-block-heading\">Download the Optimizing Vancomycin AUC Dosing at University Hospitals of Leicester NHS Trust Case Study<\/h2>\n\n\n\n<div class=\"wp-block-buttons is-horizontal is-content-justification-left is-layout-flex wp-container-core-buttons-is-layout-7e5fce0a 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\/dmrx_nhs_case_study\" target=\"_blank\" rel=\"noreferrer noopener\">Download<\/a><\/div>\n<\/div>\n<\/div><\/div>\n<\/div>\n<\/div>\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\">Demandez une d\u00e9mo<\/h2>\r\n\t<p>D\u00e9couvrez \u00e0 quel point DoseMeRx est facile \u00e0 utiliser et \u00e0 int\u00e9grer dans votre journ\u00e9e de travail.<\/p>\n<p>Demandez une d\u00e9mo ci-dessous. 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ginput_container_text'><input name='input_1' id='input_11_1' type='text' value='' class='large'    placeholder='Pr\u00e9nom *' 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'>Nom<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='Nom *' 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'>H\u00f4pital<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='H\u00f4pital *' 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'>Nombre de sites<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='Nombre de sites *' 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'>T\u00e9l\u00e9phone<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='T\u00e9l\u00e9phone *' 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'>Questions ou commentaires<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_14' id='input_11_14' class='textarea large'    placeholder='Questions ou commentaires'  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='216.73.216.152' \/><\/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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Significantly fewer patients missed vancomycin doses in the DoseMeRx group, which can have direct implications on improving medication safety. The use of DoseMeRx resulted in a significantly higher proportion of patients who reached the therapeutic AUC24 target, leading [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":8216,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[26],"tags":[28,52],"article-type":[48],"class_list":["post-8137","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-vancomycin","tag-auc","tag-optimizing"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Optimizing Vancomycin AUC Dosing in Vascular Surgery Patients at University Hospitals of Leicester NHS Trust &#8226; DoseMeRx<\/title>\n<meta name=\"description\" content=\"The study at Glenfield Hospital, University Hospitals of Leicester NHS Trust, compared vancomycin AUC outcomes in vascular surgery patients.\" \/>\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\/fr\/vancomycin\/case-studies\/optimizing-vancomycin-auc-dosing-case-study\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Optimizing Vancomycin AUC Dosing in Vascular Surgery Patients at University Hospitals of Leicester NHS Trust &#8226; 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