Less is More: Optimizing Patient Outcomes via Innovative Vancomycin Therapeutic Drug Monitoring

Vancomycin is a glycopeptide antibiotic with bactericidal activity against a wide array of gram-positive bacteria. Vancomycin levels are routinely monitored to ensure both treatment safety and efficacy. Historically, vancomycin serum trough levels have been utilized as the main modality for vancomycin therapeutic drug monitoring (TDM). However, recent literature has shown area-under-the-curve (AUC)-based vancomycin monitoring is associated with decreased rates of nephrotoxicity via reduced overall vancomycin exposure without compromising treatment efficacy for serious infections including those caused by methicillin-resistant Staphylococcus aureus (MRSA) when compared to trough-based monitoring.

The goal of this project was to optimize patient outcomes related to vancomycin utilization following the implementation of AUC-based monitoring software. The intended outcomes included a relative reduction in vancomycin-associated nephrotoxicity and associated costs by at least 20%, achievement of at least 75% of vancomycin levels drawn with AM labs, and an absolute reduction in vancomycin administered (in mg) and associated costs by at least 5%.