Looking at the Slow Adoption of AUC-Based Monitoring for Vancomycin
Abdulwhab Shremo Msdi, PharmD, offers insights on its complexities, why institutions have been slower to include this dosing technique, and why clinicians need to consider this approach.
The development of the AUC-based vancomycin monitoring guidelines published in 2020 by the Infectious Diseases Society of America provided an updated foundation for clinicians and institutions to begin to utilize it, but there is a lot of nuance that needs to be considered when utilizing it.
Implementation of AUC-based vancomycin monitoring nationwide is moving in the right direction but it is still too slow for those who advocate for it. Abdulwhab Shremo Msdi, PharmD, says it is trending positively, but he also acknowledges it’s a major step from trough based dosing.
“It's a big step, because AUC require 2 levels, so the hospital needs to coordinate with the nursing [staff] to get the 2 levels within the right interval, then you can characterize the whole exposure for the dosing interval,” Msdi said. “Whereas, before in a lot of these hospitals, they use just single trough, and then they use it as a surrogate. We know it's not ideal, but it's easy, so I think that's the main barrier…Hospitals need time to do that.”
Back in the fall, Msdi coauthored an article on the topic and provided novel equations behind vancomycin dosing utilizing this approach. (See the article below.)
Read More: Optimizing Vancomycin Therapy: A Review of AUC Calculation Techniques
In part 1, of a 2-part interview, Msdi provides comprehensive feedback on why there remains shortfalls in institutions using this technique, and its overall value.
