A Canadian perspective on the revised 2020 ASHP-IDSA-PIDS-SIDP guidelines for vancomycin AUC-based therapeutic drug monitoring for serious MRSA infections.

Background: A revised consensus guideline on therapeutic drug monitoring (TDM) of vancomycin for serious methicillin-resistant (MRSA) infections was recently published with endorsement of numerous American pharmacy and medical societies. Changing practice from trough TDM to area-under-the-curve-(AUC)-guided dosing was suggested.

Methods: Recent literature was critically appraised to determine whether AUC TDM is appropriate for Canadian hospital practice.

Cost comparison of linezolid versus vancomycin for treatment of complicated skin and skin-structure infection caused by methicillin-resistant Staphylococcus aureus in Quebec.

Background: In Canada, complicated skin and skin-structure infection (cSSSI) caused by methicillin-resistant Staphylococcus aureus (MRSA) is usually treated with antibiotics in hospital, with a follow-up course at home for stable patients. The cost implications of using intravenous and oral linezolid instead of intravenous vancomycin in Canadian clinical practice have not been examined.

Objectives: To evaluate the potential treatment cost impact for the Quebec health care system of linezolid versus vancomycin for MRSA-related cSSSI therapy, using a net impact analysis approach.

Antimicrobial stewardship in acute care centres: A survey of 68 hospitals in Quebec.

Background: Antimicrobial stewardship programs (ASPs) and quantitative monitoring of antimicrobial use are required to ensure that antimicrobials are used appropriately in the acute care setting, and have the potential to reduce costs and limit the spread of antimicrobial-resistant organisms and Clostridium difficile. Currently, it is not known what proportion of Quebec hospitals have an ASP and/or monitor antimicrobial use.

Objectives: To determine what proportion of Quebec hospitals have an ASP, and what is the nature of such a program.