PRELIMINARY OUTCOMES OF VANCOMYCIN THERAPEUTIC DRUG MONITORING IMPLEMENTATION AT TAM ANH GENERAL HOSPITAL: A RETROSPECTIVE STUDY
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Abstract
Background: Therapeutic drug monitoring (TDM) is an important tool for optimizing vancomycin dosing by individualizing dose adjustment, thereby maximizing treatment efficacy, minimizing toxicity, and limiting bacterial resistance.
Objective: To evaluate the initial outcomes of implementing vancomycin therapeutic drug monitoring and to identify factors associated with achieving the target area under the concentration–time curve (AUC) of 400–600 mg.h/L at the first TDM assessment using logistic regression analysis.
Subject and Method: A retrospective descriptive study was conducted in hospitalized patients aged ≥ 18 years who were not receiving dialysis or other forms of renal replacement therapy, received intermittent intravenous vancomycin, and underwent TDM between June 2025 and April 2026. The AUC was estimated using the SmartDoseAI software to guide dose adjustment, with a target AUC of 400–600 mg.h/L.
Result: A total of 46 patients were included in the study. Most patients were male (63%), with a median age of 62.5 years. The cumulative proportion of patients achieving the target AUC of 400–600 mg.h/L increased from 37% at the first TDM assessment to 63% by the third assessment, and 63% of patients achieved the target AUC at least once during treatment. No acute kidney injury according to the serum creatinine component of the RIFLE criteria was observed during vancomycin treatment. Multivariable logistic regression analysis showed no statistically significant factors associated with target attainment (p > 0.05). Although statistical significance was not reached, initial dose consultation provided by a clinical pharmacist showed a trend toward improved target attainment at the first TDM assessment (OR = 3.64; 95% CI: 0.95–16.41; p = 0.059).
Conclusion: This study provides preliminary evidence supporting the feasibility of implementing vancomycin therapeutic drug monitoring at Tam Anh General Hospital, Hanoi, and serves as a basis for developing and refining the hospital’s TDM program in the future.
Keywords
Vancomycin, therapeutic drug monitoring, TDM, area under the concentration–time curve, Bayesian approach
Article Details
References
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