Monitoring Vancomycin Area Under the Curve Dosing

A medical center wanted to review prescribing and documentation practices for their pharmacists.

As more medical centers move towards vancomycin area under the curve (AUC) dosing, and away from trough based dosing, infectious disease specialist Aaron Hamby, PharmD, The Medical University of South Carolina Health, says he and his colleagues wanted to understand the indications for AUC-based dosing and monitoring.

They performed a retrospective chart review of all adult patients who received vancomycin in January 2021, three months post implementation of AUC-based dosing, and examined dosing and monitoring appropriateness and compliance of documentation.

“Analysis showed that 96% of iVents and 90% of progress notes were documented correctly,” Hamby et al wrote in their study. “Overall, AUC-based protocol was appropriately selected in 92% of the patients, but only followed through for 88%. Correct documentation was noted in 93% of the patients analyzed.”

The investigators concluded that the AUC-based vancomycin dosing and monitoring initiative was successful at their institution. They also identified opportunities for further education including defining which types of infections should utilize AUC-based monitoring and ensuring correct levels are ordered when AUC-based monitoring is utilized.

The study, “Evaluation of Vancomycin Area Under the Curve Monitoring at Large Academic Medical Center,” was presented at the 24th Annual Making a Difference in Infectious Disease (MAD-ID) Meeting 2022 in Orlando, Florida from May 18-21.

Contagion spoke to Hamby at the MAD-ID meeting who provided more information about the study’s findings.